Leg lengthening surgery is a surgical treatment performed to lengthen a leg much shorter than the other leg due to a birth abnormality. This medical condition interferes with proper bone growth or a poorly healed injury. Over several weeks or months, the method gradually separates a leg bone, allowing the body to create new bone cells to fill in the space until both legs are the same length. The newly lengthened bone will take several months to consolidate and cure, necessitating physical therapy to restore adequate joint mobility and muscle strength.

What Is Leg Lengthening Surgery?

Leg lengthening surgery is an inpatient operation performed in a hospital that leverages your body’s capacity to produce new bone. At the same time, soft tissue, nerves, and blood vessels expand slowly over time to lengthen a leg that is shorter than your other leg. One of your leg bones will be sliced, and a metal lengthening device implanted, which gradually distracts, or increases the space between, the bones. This procedure is carried out progressively at around 1 mm per day until the required bone length is reached. Your body will manufacture new bone cells to fill up the area as the leg bone is gradually diverted. An external fixator or an internal lengthening nail can be used to divert the bone:

  • A metal frame that stands outside the leg and is attached to the bone by pins, screws, and wires is known as an external fixator. The external fixator can be adjusted from the outside to expand the space between the two sliced sections of the leg bone.
  • An internal lengthening nail is a motorized metal nail or rod placed into the leg bone’s bone marrow cavity. It is controlled by a remote control device that rotates a magnet in the nail, causing the nail to extend like a telescope and gradually lengthen the bone.

Once the desired length is reached, the metal lengthening device will be left in place for several months until the bone heals and solidifies completely. In outpatient surgery, the lengthening device will be surgically removed. After fully developed, the new bone is just as strong as any other bone and is not at higher danger of weakening or breakdown.

Potential Risks

Leg lengthening surgery can help address substantial leg length inequalities, but it is not without dangers.

  • Bone infection (osteomyelitis)
  • Poor bone healing
  • Bone growth restriction
  • Nerve damage
  • Injury to surrounding muscles and blood vessels

Always examine the potential dangers of leg lengthening surgery with your doctor to determine if it is a suitable option for you, given the magnitude of your leg length disparity and how it affects your daily functioning.

Purpose of Leg Lengthening Surgery

Many candidates for leg lengthening surgery have two legs that are different lengths as a result of:

  • A congenital disability
  • Growth plate injury to a leg bone as a child
  • Malunion of a previous fracture where the leg bone heals out of alignment
  • Nonunion of a previous fracture where the leg bone does not heal at all

Patients with skeletal dysplasias or other bone diseases may also be candidates for leg lengthening surgery if there is a considerable discrepancy in leg lengths between the right and left sides, interfering with their ability to walk and move normally. Other conditions that might result in a significant leg length disparity and necessitate leg lengthening surgery include:

  • Poliomyelitis
  • Cerebral palsy
  • Legg-Calve-Perthes disease

Suppose you suspect you have a leg length discrepancy. In that case, you should have a physical examination performed by an orthopedic healthcare provider to determine whether there is an actual leg length discrepancy due to different leg bone lengths or an apparent leg length discrepancy in which one leg appears to be shorter even though both leg bones are the same length. Problems with the spine, hips, or sacroiliac joints can cause apparent leg length differences. Physical therapy is frequently beneficial in restoring proper muscle and joint alignment to remedy the problem. If your doctor feels you have a legitimate leg length difference, x-rays will be taken to confirm the bone length difference. If you have an apparent or genuine leg length disparity, a heel lift or shoe lift can be put to your footwear to add extra height to balance your leg lengths and make walking and standing more comfortable. Significant leg length differences may necessitate surgery to rectify.

How to Prepare

The surgical team will give you more specific instructions on what you need to do in the days and hours leading up to the surgery. To encourage optimal healing and seamless recovery, it is recommended that you stay active, consume a balanced diet, and stop smoking before any procedure. Certain drugs may need to be discontinued in the days leading up to surgery to avoid excessive bleeding or anesthetic interaction during the procedure; before using any prescriptions, over-the-counter drugs, or supplements, always with your doctor. Typically, you will be hospitalized for two to three days following the operation. You will not be permitted to drive to or from the hospital before or after your surgery, so make plans for a friend or family member to drive you there and back. Minimizing stress and prioritizing excellent mental and emotional health is also helpful for lowering inflammation levels in the body and assisting in your recovery. The better your health is before surgery, the easier your recovery and rehabilitation will be.