Leg Lengthening

by Cynthia M. Johnson, MA

Definition

This procedure uses surgery and devices to correct a leg length difference over a period of time. The process triggers bone growth and soft tissue lengthening.

Reasons for Procedure

This procedure may be done on people who have a length difference due to:

Trauma, such as a leg fracture
Bone infection
Tumors
Congenital defect or other condition that affects bone growth, such as Klippel-Trenaunay syndrome
Short stature, such as dwarfism
Polio
Cerebral palsy

Leg lengthening can improve walking and lower the risk of other problems. Several inches of leg length may be added.

Possible Complications

Problems are rare, but all procedures have some risk. The doctor will go over some problems that could happen, such as:

Excess bleeding
Problems from anesthesia, such as wheezing or sore throat
Infection
Blood clots
Joint stiffness
Bone length may be longer or shorter than planned
Muscle contraction (muscle shortens)
Nerve injury
Problems with the new bone forming

Things that may raise the risk of problems are:

Smoking
Drinking alcohol
Chronic diseases, such as diabetes or obesity

What to Expect

Prior to Procedure

The surgical team may meet with you to talk about:

Anesthesia options
Any allergies you may have
Current medicines, herbs, and supplements that you take and whether you need to stop taking them before surgery
Fasting before surgery, such as avoiding food or drink after midnight the night before
Arranging for a ride to and from surgery
Tests that will need to be done before surgery, such as images

Anesthesia

The doctor may give:

General anesthesia—you will be asleep
Spinal anesthesia —you will be numb from the belly down

Description of the Procedure

This procedure will be done in stages. The first stage is a procedure called an osteotomy. An incision will be made in the leg and the bone will be cut. A leg fixation device will be selected. This will stabilize the bone while it is being lengthened. Options are:

External fixation device—This framed device is positioned around the leg. Pins and wires are placed through the skin and tissue to reach the bone and lengthen it. Some have a dial attached to the frame. This dial is turned to slowly lengthen the bone.
Internal fixation device—This is placed inside the leg. It is positioned on the bone. Some of these devices have a nail with a tool that automatically lengthens the bone. In some people , it is used with the external device.

This stage may start a few days or weeks after the osteotomy and last for a couple of months. The body will slowly regenerate new bone in the small space that was created between the bone ends.

The bone heals during the next stage. X-rays will be taken. The fixation devices will be removed when the healing is complete.

How Long Will It Take?

The osteotomy can take about 2 hours.

The lengthening process can take 2 to 3 months.

Will It Hurt?

Pain and swelling are common in the first few weeks. Medicine and home care can help.

Average Hospital Stay

The usual length of stay is 1 to 3 days. If you have problems, you may need to stay longer.

Post-procedure Care

At the Hospital

Right after the procedure, the staff will:

Give you pain medicine
Encourage you to walk using crutches or a walker
Teach you how to care for and adjust the fixation device

During your stay, the hospital staff will take steps to lower your risk of infection, such as:

Washing their hands
Wearing gloves or masks
Keeping your incisions covered

There are also steps you can take to lower your risk of infection, such as:

Washing your hands often and reminding visitors and staff to do the same
Reminding staff to wear gloves or masks
Not letting others touch your incisions

At Home

The process can take up to 6 months to complete. Physical activity will be limited during this time. You will need to ask for help with daily activities and delay your return to work.

Call Your Doctor

Call the doctor if you are not getting better or you have:

Signs of infection, such as fever, chills
Redness, swelling, excessive bleeding, or discharge around the incision or pin and wire sites
Pain that you cannot control with medicine
Pain and swelling in the feet, calves, or legs
Numbness, tingling, or loss of feeling in the leg, knee, or foot

If you think you have an emergency, call for medical help right away.

RESOURCES:

American Orthopaedic Association
http://www.aoassn.org

Ortho Info—American Academy of Orthopaedic Surgeons
http://www.orthoinfo.org

CANADIAN RESOURCES:

The Arthritis Society
http://www.arthritis.ca

Canadian Orthopaedic Association
http://www.coa-aco.org/patient/public-information.html

References:

Klippel-trenaunay syndrome. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/klippel-trenaunay-syndrome. Accessed August 2, 2021.

Limb length discrepancy. Ortho Info—American Academy of Orthopaedic Surgeons website. Available at: https://orthoinfo.aaos.org/en/diseases--conditions/limb-length-discrepancy. Accessed August 2, 2021.

Limb lengthening: An overview. Hospital for Special Surgery website. Available at:
...(Click grey area to select URL)
Accessed August 2, 2021.

Limb lengthening. Scottish Rite Hospital for Children website. Available at:
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Accessed August 2, 2021.

Last reviewed July 2021 by EBSCO Medical Review Board Warren A. Bodine, DO, CAQSM
Last Updated: 8/2/2021

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