Limb Lengthening & Deformity Correction

Performed by Dr. Lokesh | Eternal Orthopaedics

At Eternal Orthopaedics, Dr. Lokesh offers comprehensive limb lengthening and deformity correction services for patients with limb length discrepancies, congenital conditions, post-traumatic shortening, or bone growth abnormalities. Using state-of-the-art technology and individualized planning, we help patients regain symmetry, function, and mobility.

Why & What is Limb Lengthening?

• Limb lengthening allows gradual extension of a bone (usually femur or tibia, sometimes upper limb bones) by controlled distraction of the bone segments, with new bone forming in the gap (distraction osteogenesis).
• Indications include:
  • Congenital limb length discrepancy (e.g. congenital femoral deficiency, hemihypertrophy)
  • Post-traumatic shortening (after fracture healing with malunion or resection)
  • Growth plate injury leading to one limb being shorter
  • Skeletal dysplasia or other growth abnormalities
  • Cosmetic, stature enhancement (in selected, carefully counseled patients)

With modern techniques, limb lengthening is safer, more predictable, and with fewer complications than older methods.

Methods & Devices We Use

At Eternal Orthopaedics, Dr. Lokesh employs several limb lengthening systems and techniques, tailored to each patient’s anatomy, amount of lengthening desired, bone quality, patient compliance, and comorbidities. Below are the options:

1. Internal Electromagnetic (Motorized) Rods (Fully Internal Lengthening Nails)

• A telescopic rod is implanted inside the bone (intramedullary).
• After osteotomy and initial healing, the rod is lengthened gradually using an external controller (remote) that activates the internal motor.
• Benefits: no external frame, better patient comfort, lower risk of pin-site infections, cosmetic advantage.
• Limitations: bone size and quality must allow intramedullary implantation; for large deformities or shorter bones external methods may still be preferred, reported cases of nail breakage is there.

2. Ilizarov (Circular External Fixator)

• One of the classic and versatile external devices.
• A circular frame with wires and rings is fixed around the bone, and fine adjustments (turning nuts) gradually distract the bone.
• Particularly useful for complex deformities (angulation, rotation) as well as lengthening.
• Advantages: excellent deformity control; can correct in multiple planes.
• Challenges: patient must manage pin-site cleaning, discomfort, and soft-tissue tethering; longer external period.

  

3. LRS (Limb Reconstruction System) / Monolateral External Fixator

• A single-side external rod/fixator along the bone, attached with pins or screws.
• Easier to apply and manage compared to circular frames, more acceptable cosmetically in some cases.
• Good for straightforward lengthening without complex multiplanar deformities.
• Pin-site care is essential.

  

4. Nail in Situ with or without Partial External Support (“Hybrid” Technique)

• This is a hybrid approach: an intramedullary nail (or a “static” rod) is already present (“in situ”) or inserted, and external fixators are used in tandem to provide controlled distraction.
• Once desired length is achieved, the external component is removed and the nail maintains stability during consolidation.
• Benefit: shorter external fixation time, improved comfort, and better stability in consolidation.

How the Procedure Works (Step by Step)

1. Preoperative evaluation & planning
   • Detailed clinical assessment, full-length standing radiographs, CT scan if needed
   • Limb length measurements, alignment assessment, soft tissue evaluation
   • Planning of osteotomy site(s), fixation method, target length, and rate of distraction
2. Surgical osteotomy & implant placement
   • Under general or regional anesthesia, Dr. Lokesh performs a controlled osteotomy (bone cut)
   • The chosen device (intramedullary rod or external fixator) is applied, ensuring stable fixation of the bone segments
3. Latency phase
   • A waiting period (commonly 5–7 days) allowing early biologic healing response before distraction begins
4. Distraction (Lengthening) phase
   • Gradual lengthening is begun — typically 0.5–1.0 mm per day in multiple small increments
   • In electromagnetic nail systems, the patient uses an external controller to adjust the rod
   • In external fixators (Ilizarov, LRS), adjustment nuts or mechanisms are turned per schedule
   • Frequent follow-up, periodic X-rays to assess regenerate quality
   • Physical therapy begins early to maintain joint motion, muscle strength, and soft tissue flexibility
5. Consolidation phase
   • Once the target length is achieved, distraction stops
   • The regenerate bone continues to strengthen and mineralize over weeks to months
   • Device remains in place (internal or external) until sufficient bone hardness is achieved
6. Device Removal (if external or hybrid)
   • For external fixators or external components in hybrid systems, removal is done via a minor surgical or outpatient procedure
   • Casts, braces or protective supports may be used briefly afterward

Advantages & Risks

Advantages

• Restore symmetry of limb length, improving gait, posture, and function
• Reduce compensatory problems (e.g. back pain, hip or knee pain) caused by discrepancy
• Modern internal systems improve comfort, reduce infection risk, and enhance patient satisfaction
• Tailored technique options allow customization according to each patient’s needs

Risks & Complications

• Poor consolidation or nonunion of regenerate bone
• Infection (especially pin-site infections in external fixators)
• Delay in bone formation or regenerate deformity
• Soft tissue tightness, joint stiffness, or contractures
• Neurovascular injury (nerve stretch or compression)
• Implant failure, bending, or mechanical breakage
• Need for secondary surgeries, adjustments
• Pain, discomfort during distraction
• Psychological stress, compliance dependency

Dr. Lokesh and the Eternal Orthopaedics team meticulously monitor and manage each of these risks through patient selection, precise surgical technique, close follow-up, and rehabilitation support.

What to Expect After Surgery & During Recovery

• Hospital stay: typically a few days post-surgery
• Mobility: use of crutches, walker or wheelchair initially; gradual weight-bearing as per radiographic signs
• Physical therapy: starts early, focusing on joint motion, muscle flexibility, and strength
• Follow-up & imaging: frequent X-rays during distraction and consolidation phases to monitor regenerate formation
• Duration: the external or device period is often estimated as “3 months per inch (≈ 2.5 cm)” of lengthening (varies by method)
• Removal: once bone is fully matured, external fixators or external components are removed
• Return to daily life: gradual, with protective supports or braces initially; full function over months

Is Limb Lengthening Right for You?

Not everyone is a candidate. You may be considered for the procedure if:

• You have a measurable limb length discrepancy or deformity significantly affecting function
• Your bone quality, soft tissues, and overall health allow safe surgery and healing
• You are motivated, compliant, and ready for close follow-up and rehabilitation
• You understand the risks, duration, and commitment involved

During a consultation, Dr. Lokesh will examine you, review imaging, explain the best options, discuss expected outcomes, and answer your questions.

Why Choose Eternal Orthopaedics & Dr. Lokesh?

• Specialized expertise in limb lengthening, deformity correction, and reconstructive orthopaedics
• Access to a full suite of techniques (electromagnetic rods, Ilizarov, LRS, hybrid methods)
• Personalized approach — selecting the best method for you
• Comprehensive surgical care, rehabilitation, and close follow-up
• Commitment to patient comfort, safety, and optimal functional outcomes

If you’d like to learn whether you are a candidate for limb lengthening, or to discuss which technique is best for your case, please contact us or book a consultation with Dr. Lokesh.