Limb leghthening
30 de July de 2023 2023-07-31 1:48Limb leghthening

LIMB LENGTHENING
EVOLUTION AND REVOLUTION OF LIMB RECONSTRUCTIVE SURGERY
Bone lengthening and correction of deformities by distraction osteogenesis techniques using external tutors was introduced by doctor Gavriil A. Ilizarov in the 1950´s in Russia. The method only spread to the West until the 1980´s through scientific exchange with Italian surgeons who popularized the method and later on in North America it was introduced in the 1990´s. The technique was developed and applyied in patients who were subjected to neglect and social uprooting due to pathologies that at that time could be solved only with amputation or death from untraceable infections or subjected to great disabilities due to deformities and severe physical limitations.
With the development of the method, the treatment of different congenital or acquired pathologies due to trauma or infection has been revolutionized, allowing patients with limb deformities, joint problems and length discrepancies or chronic infections to find comprehensive solutions to their problem. During the last decade, with the subspecialty in this type of surgery, the application of refined principles and techniques, it has been possible to impact and change the medical and social perception about the final result of these cases, with the appearance of the concepts of joint preservation surgery and bone reconstruction, and full recovery of the extremities. Additionally, with the support of bioengineering and advanced technologies in the development of highly precise and biocompatible devices, it is possible to guarantee the proper application of the method without the mechanical complications previously encountered.
External tutors with dynamic stability allow a comfortable and effective way to correct deformities and lengthen bones through an osteotomy by slowly and progressively lengthening them at a speed of 1mm per day, which implies that in a 4 month period it is posible to develop up to 10 centimeters of new bone, with the biological characteristics of normal bone. This allows lengthening all the neuromuscular and vascular structures of the extremities, without causing irreparable damage or alterations; this in combination with adequate care and comprehensive rehabilitation, makes it possible to change a whole series of pathologies or consequences of traumatic injuries, with the resection of bones damaged by infections or tumors, aligning deformed bones, balancing length discrepancies or lengthening short people who have functional problems in their daily activities. It is a revolutionary treatment that requires very careful management by the patient in conjunction with an expert specialist to avoid complications that lead to failure or loss of a limb. Excellent results can be achieved with the combination of the distraction osteogenesis method and the early installment of internal fixation systems with angular stability, a technique applied and developed by Dr. Mora worldwide, that allows more comfortable limb reconstruction, with faster recovery periods reducing the use of external tutors more than 30
Limb reconstructive surgery allows solving complex and serious problems that cannot be treated with traditional or conventional methods, allowing the salvage of limbs at high risk of amputation and with effective and timely treatment that offers an excellent alternative in high-cost diseases and disabilities.
ABOUT COSMETIC LIMB LENGTHENING – HEIGHT INCREASE
Height increase can be performed with different devices, including Internal ones such as the Intramedullary Nail (PRECICE® Nail) or external monolateral or circular tutors. The best treatment option is should be defiend on a cases by cases basis.
What are the requirements for a bone lengthening?
Individuals in good health with no presence of an active infection or metabolic diseases. It can be done at any age.
What is the recovery time when lengthening with the Precice® Nail?
Normally it takes 3 months to elongate up to 8cms. It is recommended to simultaneously lengthen both sides, be it the femurs or the tibias. Daily physical therapy and adequate management of the elongation is required. There is an 80% load-bearing restriction during the elongation period, which is gradually decreased according to the maturation of the bone; after completion of the elongation period, another 3 months are required for complete bone consolidatation that allows the patient to exercise safely. Approximately one year after limb lengthening has been completed, any type of high-impact physical exercise can be performed.
If I live outside of Medellín or abroad, what would the logistics of the treatment be like?
The surgery is performed in recognized hospitals that are internationally certified to perform this type of highly complex treatment and comply with all international safety and technology standards. The treatment plan and costs include, lodging, food, nursing care, personalized physical therapy sessions and everything related post-surgical care. Patients must plan and are required to stay in Medellín during a 3-month period, after which they may return home and will be followed and monitored on-line during another 3-month period.
Is the recovery painful and what are the possible complications?
As with any surgical procedure, complications may occur, but the most important thing is to avoid preventable ones and that the patient be supervised by a group of experts in bone lengthening to detect and treat any adverse situation early. The most common situations that may occur are muscle contractures due to lack of physical therapy, delayed bone maturation and pain and discomfort due to inadequate pharmacological management and analgesia. Overall, if lengthening is managed efficiently and carefully, the percentage of complications is very low.
What are the approximate costs of treatment?
In general, bone elongation devices are expensive due to the highly sophisticated and advanced technology used such as that of intramedullary Precice® Nail. The cost of each nail is approximately US$18,000. External tutors vary in cost depending on their origin and quality. Additionally, hospitalization, a 3- month physical therapy plan and medical team fees must also be covered. Costs vary depending on the city and location of the hospital and medical fees where it is performed. In the US there are centers where comprehensive treatment exceeds US $200,000 US with an average of US$120,000. In Europe the average is US$100,000 euros. In Medellín-Colombia with the Cora Group, the complete treatment ranges between US$ 30,000 and 60,000 dollars depending on the device used. Most importantly however when taking the decision where to carry out the procedure, is to consider the experience and expertise of the rehabilitation team, which in our case is backed by more than 20 years of experience in bone lengthening treatments.
Are there any additional recommendations?
It is very important to be convinced of the treatment, to be properly informed about the center that offers the lengthening procedure, and the experience of the specialist. Full time commitment and dedication to physical therapy and care during post-surgical lengthening process, activities that involve walking or distance movements are not recommended during this period, a personalized and face-to-face consultation should always be carried out before undergoing surgery for to perform a thorough clinical exam and analysis of the limb to be lengthened, as well as to personally answer, explain clarify specific doubts with the patient and his family , given that highly specialized and complex nature of the treatment.
We are a center specialized in reconstructive surgery and bone lengthening, that offers more than 25 years of experience, state of the art technology and that is highly recognized worldwide.
We hope this information will be useful to you in your quest to increase your height or if you require any type of bone lengthening procedure.