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In Our Limb Lengthening and Reconstruction Clinic, We Perform These Progressive Elongation Treatments in Patients with Short Stature.

1st. SYMPOSIUM ON WOUND CARE IN ORTHOPEDIC AND RECONSTRUCTIVE LIMB SURGERY

Program for the SURGICAL TUTORIAL course on TECHNIQUES IN RECONSTRUCTIVE AND LIMB LENGTHENING SURGERY.

KEY QUESTIONS TO BE ANSWERED Is it possible to increase height? Up to how many centimeters? Are there any medications, hormones, procedures, or girdles that increase height without surgery? If I am short, without any medical condition, can I undergo bone lengthening? What is the surgical procedure, what does the surgery consist of, and how long does the complete treatment take? What are the risks and complications I might face? Is this a dangerous surgery? Are these treatments performed well in Colombia? Is there good technology, or, like in the past, do you have to leave the country? Is the treatment very expensive? Is it covered by insurance or EPS? QUESTIONS WITH ANSWERS: 1. Is it possible to increase height? Up to how many centimeters? Of course it is possible to increase height, but the only way after the period of bone growth has ended is with bone lengthening surgery. Humans grow through the growth plates in their bones (physes), and these close completely during adolescence. In women, they close up to ages 12-16, and in men, they grow until ages 14-18. Once the growth plate is closed, there is no way to increase height except through surgery. In theory, you can lengthen a bone as much as you want, but you have to consider that it’s not just the bone that is lengthened; the blood vessels, nerves, muscles, and tendons are also stretched. Stretching these structures can cause changes and limitations in mobility, which is why the lengthening method must be completely supervised and managed by experts in the field. In addition, it is required that the elongation is controlled. You can safely lengthen at a rate of 1 millimeter per day to avoid damage to the vital structures. The patient must undergo this lengthening with an external device (an external fixator) or with new technologies, using an internal device, an intramedullary nail with magnetism. What is currently recommended to avoid complications is to lengthen an average of 20-30% of the bone’s length. This means it’s recommended not to lengthen a femur by more than 8 centimeters and a tibia and fibula by 6 to 8 cm. So, for lengthening for short stature, up to about 15 centimeters can be achieved in the first stage of treatment. In some cases of diseases like achondroplasia or hypophosphatemic rickets, several stages of lengthening are performed every 2 to 3 years to achieve greater lengthenings, up to 40-60 centimeters. 2. Are there any medications, hormones, exercises, or girdles that increase height without surgery? Growth hormone is naturally produced by the human body and stimulates the growth of all organs, including bones, but the bone grows until the growth plate naturally closes. In very rare cases, the body does not produce the hormone adequately in childhood, and in this case, it would be the treatment of choice before the growth plate closes. In adults, it would have no effect or indication because there would be no way to stimulate the growth plate. Therefore, it is not indicated, nor are there any natural products or vitamins that can replace it. Growth through exercise or special postures during the night or day do not actually increase height. This is a form of deception. The only thing that is true is that you should have good body posture so that the appearance of height is real. For example, people who walk a little hunched over can look taller and more erect if they improve their posture, but they are not actually growing; they are just improving their body posture. Therefore, books or brochures that promote gaining 10 to 15 centimeters are really a deception. There is no medication of any kind or vitamin that actually produces an increase in height. Publications on social networks or the internet that base their advertising on being able to grow up to 10 to 20 cm with just exercise in 2 to 3 months are misleading publications, based on false cases of growth. 3. If I am short, without any medical condition, can I undergo bone lengthening? Cosmetic lengthening or height increase with surgery should be a personal decision for the patient. The patient is the one who, in their view of their personal image, feels and lives with the discomfort of feeling short compared to others. For this reason, it must be clear what they want and they must be willing to undergo the surgical treatment. There is no measurement or height limit to define as a parameter for short stature from a cosmetic standpoint. A man who is 165 cm tall in Peru may be of normal height, but in the USA or Europe, he would be considered short. The important thing is the individual analysis of the case, to define the goals of the lengthening and what is expected at the end of the treatment, as well as the decision to undergo a surgical treatment that requires care and physical therapy, that will incapacitate you for a few months, and that will require all your attention to ensure everything goes well. 4. What is the surgical procedure, what does the surgery consist of, and how long does the complete treatment take? A complete process of preparation and comprehensive visualization of the treatment is carried out. The first thing is a specialized medical consultation with the orthopedist who is an expert in bone lengthening of the limbs. With them, the treatment and goals are discussed. A comprehensive clinical evaluation of the patient is performed to detect possible alignment disorders of the limbs, contractures, muscle stiffness, or deformities that may require special care during the treatment. The period of the surgery, the physical therapy and rehabilitation plan, the surgical budget, and the type of device to be used for bone lengthening (an external fixator or an intramedullary lengthening nail, Precice nail) are all planned. A pre-surgical evaluation is performed by the anesthesiologist before the surgical treatment. Then, in the operating room, a low-energy osteotomy is performed on the

Osteomyelitis is an acute or chronic infection of the bone or bone marrow, normally caused by a pyogenic bacterium or mycobacterium and fungi

We were awarded at the International Congress of Lengthening and Reconstructive Surgery held in Miami at the World Congress of the ILRRS (International Limb Lengthening and Reconstruction Society) and ASSAMI Worldwide. As the best Clinical Symposium of the congress. We were also recognized with the Award for the best Poster at the 61st SCCOT National Congress. 2016. These recognitions before the world are a sign of the daily effort to perform Orthopedics and Traumatology of the highest quality, applying the most innovative treatments with high technology for the solution of complex problems in traumatology. We will continue to provide a comprehensive service that combines the most modern technology, associated with a professional service from the most recognized specialists in Latin America and the world. Comprehensive management of bone lengthenings (Limb Lengthening) in Trauma and cosmetic lengthening (Cosmetic Limb Lengthening). Management and Rehabilitation in infectious processes, Non-union of Fractures and Acute or chronic Osteomyelitis (Osteomyelitis).

OCTOBER 31 TO NOVEMBER 2, 2016 10th Course on Principles in Malalignment 2nd Master Course in Osteotomies NOVEMBER 2 TO 4, 2016 Latin American Society of Pediatric Orthopedics Congress – SLAOTI 5th Course on Complications in Trauma and Reconstructive Surgery REGISTRATION OPEN: http://supersemana2016.com/tickets/ Congress Director: León Mora H. MD. SLAOTI President: Miguel Galbán MD. Director of Osteotomies: Theddy Slongo Director of Trauma: JhonByron Alzate MD. Director of Malalignment: Carlos Sarassa MD. INTERNATIONAL GUESTS: Dror Paley. MD. West Palm Beach. USA Theddy Slongo MD. Bern. Switzerland Alexander Kirienko MD. Milan. Italy Alexander Cherkachin MD. Texas. USA Michael Suk MD. USA Bruce Ziran. MD. Atlanta. USA Nuno Craveiro Lopes MD. Lisbon. Portugal Miguel A. Galbán. MD. Caracas, Venezuela Peter Gianoudis. MD. Leeds – France Daniel Green, MD – USA Francois Fassier, MD. Montreal – Canada Information and Pre-registration: cursos2016medellin@gmail.com slaoti2016@gmail.com www.coragroup.com.co www.doctorleonmora.com

Learn about the Conference of Dr. Gonzalo León Mora at the 23rd annual Scientific Meeting held on July 19 and 20, 2013 in New York City,

Dr. León Mora participated in the XV Congress of the Argentine Association for the Study of Bone Reconstruction and Lengthening in Rosario, Argentina,