Limb Lengthening

Shortening of a limb can be congenital, can occur in the context of metabolic disorders or syndromes, or can result from trauma and fracture. It often occurs together with an axial malalignment (bowlegs or knock-knees). Depending on the amount of the length discrepancy, different options for treatment are available.

Lengthening Nails

A lengthening nail (Precice; NuVasive, Inc., San Diego, California, USA) is inserted into the bone. It can then be slowly, gradually distracted with the use of external remote control until the desired length is achieved.

Precice Verlängerungsmarknagel Kinder und Erwachsene Beinverlängerung Phase 1
Phase 1: Insertion of the lengthening nail after osteotomy (cutting of the bone) (image: OSS)
Precice Verlängerungsmarknagel Kinder und Erwachsene Beinverlängerung Phase 2
Phase 2: Gradual distraction of the nail and bone (image: OSS)
Precice Verlängerungsmarknagel Kinder und Erwachsene Beinverlängerung Phase 3
Phase 3: New bone is regenerating (image: OSS)
Precice Verlängerungsmarknagel Kinder und Erwachsene Beinverlängerung Phase 4
Phase 4: After the bone has healed, the nail can be removed (image: OSS)

External Fixation

If shortening of the bone is combined with a complex deformity, a six-axis external fixation frame, such as the Taylor spatial frame (Smith & Nephew, Memphis, Tennessee, USA), can be used.

Growth Modulation

Sometimes lengthening of the shorter limb is not the best choice. For minor limb-length discrepancies, or if your child is predicted to grow excessively tall, the longer limb can be prevented from further growth.

This is done by closing (destroying) one or both growth plates near the knee during a short surgery. A bone bar forms in the area of the growth plate and stops further growth from that plate.