Limb Lengthening Surgery | FAQ
Q:-What is the complication rate?
A: -Our complication rate is very low, because our accepted technique is one of the most reliable. But even this method and our solid experience cannot guarantee a 0% complication rate. In our experience we have had:
- primary bone union in the process of limb lengthening;
- insignificant callus malunion after frame removal;
- broken pins;
- metalosis (individual allergy for metal);
- stiffness of joint ROM.
These sporadic cases can be considered obstacles rather than complications, because they did not affect final results. A serious issue is the delay of restoration of joint ROM and gait. All cases encountering this problem were found in procedures that were interrupted in Armenia because patients, due to various problems related to their family, left Armenia to return to their place of residence, where they were not given proper physical therapy. We strongly recommend that all our foreign patients make a serious decision to completely dedicate the necessary time for esthetic limb lengthening from the beginning to a successful end.
Q:-I am concerned about scar tissue left after the procedure.
A-The incision we make for a bone cut is, as a rule, 5-10mm long, so it hardly can be seen after it heals. Spots of scar tissue are left from pins and especially half pins. In a majority of cases, they are insignificant and do not bother patients. In some cases, we suggest the use of ointments that help to erode the scars and help healthy skin to regenerate. New technologies of skin shaping by laser also can be helpful. Important: scar tissue depends not only on surgical technique, but also on individual characteristics of the patients’ skin.
Q: – What is maximum length you can do?
A: – In our practice we have increased length 16 cm (6.2 inches)for cosmetic reasons. This was indicated because of obvious disproportion between the patient’s body and legs. Theoretically, there is no limit. For patients with dwarfism (achondroplasia) we have done lengthening of 32 cm in two periods. The problem is to estimate comprehensively how much any particular patient ultimately needs to make him proportional. Proportion between the tibia (lower leg) and the femur (upper leg) is also very important. With some frequency, potential patients ask us to lengthen tibias only by 8 or 10cm. We never do this. Priority №1 for us is the final esthetic result, and beyond that, biomechanical correctness. ( See also what we mean by saying perfect legs).
Q-How long does the procedure take?
A: – It is a lengthy procedure. Simultaneous lengthening of both tibias from one cut takes 20-25 days per each cm of length. This includes both lengthening and fixation periods. Lengthening from two cuts (2mm per day lengthening) shortens the procedure by 40%. Cross lateral two stage tibia/femur lengthening takes longer, because a rehab period is necessary between lengthening sets. 10 cm lengthening, for example, takes about 11 months, including two sets and rehabilitation. Important: the duration of fixation, rehabilitation and the whole procedure depends very much on the patient’s motivation, his willingness to cooperate with the physical therapist, and his willingness to be physically active.
Q: – What shall I bring with me?
A: Even though we provide appropriate cloths nevertheless it is better to bring modify underpants or boxers, at least a pair of modified shorts for summer and pants for winter. Climate in Armenia is continental. We have short cold winter, rainy spring, hot summer and beautiful fall. To see more about Armenia… Usually, the size of frame increases diameter of limb up to 60%. Bring things that you enjoy like movies, books, music, personal photos, etc. They fill your spare time and keep you going. Just bring something to do. Set yourself with goals and achievements no matter how small they seems to be, something that improves your professional or personal skills. It can be anything for instance improve your typewriting, fast reading, learn a new language, etc. Most of these things you may find on the Internet but some not and it’s better if you have them before.