Leg lengthening/shortening

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Leg lengthening - series

While the child is under general anesthesia, the bone to be shortened is cut and a section of bone is removed. The ends of the cut bone will be joined and a metal plate with screws or a nail down the center of the bone is placed across the bone incision to hold it in place during healing.

Because the blood vessels, muscles, and skin are involved, careful and frequent checking of the skin color, temperature, and sensation of the foot and toes is necessary to prevent circulatory, muscular, or nerve damage.

BONE GROWTH RESTRICTION

Bone growth takes place at the growth plates (physes) at each end of long bones. Restricting bone growth may be recommended for children whose bones are still growing. It is used to restrict the growth of a longer bone to allow the shorter bone to continue to grow to match its length.

While the child is under general anesthesia, the surgeons make an incision over the growth plate at the end of the bone in the longer leg.

Destroying the growth plate by scraping or drilling it (epiphysiodesis or physeal arrest) will restrict further growth at that growth plate. Proper timing of this surgical treatment is important to assure good results.

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.

Surgical treatment may be recommended for severe unequal leg lengths caused by the following:

• Poliomyelitis and cerebral palsy
• Small, weak (atrophied) muscles or short, tight (spastic) muscles which may cause deformities and prevent normal leg growth
• Hip diseases such as Legg-Perthes disease
• Previous injuries or bone fractures that may stimulate excessive bone growth
• Birth defects (congenital deformities) of bones, joints, muscles, tendons, or ligaments

In general, leg lengthening is considered for large differences (more than 5 cm). Leg shortening or restricting is considered for smaller differences (less than 5 cm). Lengthening is also considered more often when the patient is short to begin with.

Review Date: 12/04/2006
Reviewed By: Thomas N. Joseph, MD, Private Practice specializing in Orthopaedics, subspecialty Foot and Ankle, Camden Bone & Joint, Camden, SC. Review provided by VeriMed Healthcare Network.