Leg lengthening and shortening are types of surgery to treat children who have unequal length legs. These procedures may:
Bone lengthening: This series of treatments involves several surgical procedures, a long recovery period, and a number of risks but it can add up to 6 inches of length to a leg. While the child is under general anesthesia:
Bone resection or removal: This is a complicated surgery that can produce a very precise degree of correction. While the child is under general anesthesia
Bone growth restriction: Bone growth takes place at the growth plates (physes) at each end of long bones. While the child is under general anesthesia, the surgeons make a surgical cut over the growth plate at the end of the bone in the longer leg.
Removal of implanted metal devices Metal pins, screws, staples, or plates may be used to stabilize bone during healing. Most orthopedic surgeons prefer to wait several months to a year before removing any large metal implants. Removal of implanted devices requires another surgical procedure using general anesthesia.
Leg lengthening procedure is considered for large differences in leg length (more than 5 cm or 2 inches). Limb extension is more likely to be recommended for those who want to lengthen their legs (Cosmetic Lengthening) or for patients who are short to begin with (surgery to increase height). Shortening a longer leg may be recommended for children whose bones are no longer growing. Bone growth restriction is recommended for children whose bones are still growing. It is used to restrict the growth of a longer bone, while the shorter bone continues to grow to match its length. Proper timing of this treatment is important to ensure good results.
Medical illnesses that lead to severely unequal leg lengths include the following:
After bone growth restriction surgery there are a few things to keep in mind
After bone shortening surgery:
After leg lengthening surgery:
The Taylor Spatial Frame (TSF) is an external fixator used by podiatric and orthopaedic surgeons to treat complex fractures and bone deformities. The medical device shares a number of components and features of the Ilizarov apparatus. The Taylor Spatial Frame is a hexapod device based on a Stewart platform, and was invented by an orthopaedic surgeon, Dr Charles Taylor. The device consists of two aluminum rings connected by six struts. Each strut can be independently lengthened or shortened. Connected to a bone by wires or half pins, the attached bone can be manipulated in six axes (anterior/posterior, varus/valgus, lengthen/shorten.) Angular, translational, rotational, and length deformities can all be corrected simultaneously with the TSF.
The TSF is used in both adults and children. It is used for the treatment of acute fractures, mal-unions, non-unions and congenital deformities. It can be used on both the upper and lower limbs. Specialized foot rings are also available for the treatment of complex foot deformities.
Once the fixator is attached to the bone, the deformity is characterized by studying the postoperative X-rays. The angular, translational, rotational, and length deformity values are then entered into a specialized software online, along with parameters such as the ring size and initial strut lengths. The software then produces a "prescription" of strut changes that the patient can follow. The struts are adjusted daily by the patient until the correct alignment is achieved. Correction of the bone deformity can typically take 3–4 weeks. Once the deformity has been corrected, the frame is then left on the leg till the bone heals. This often takes 3–6 months, depending on the nature and degree of deformity.
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