What is Bone Lengthening?

Bone lengthening surgery is a procedure used to change the length of a limb. This is usually done on the legs or arms. The surgery is typically used to correct deformities of the limbs and even out limbs of differing lengths, but it is sometimes also used by people of short stature who wish to become taller.

Techniques continue to advance as medical knowledge and technology improve, but the procedure most commonly associated with this type of surgery involves "stretching" the bone. This technique, called distraction osteogenesis, capitalizes on the ability of bone to grow back together when held apart at a slight distance.

The mechanism of this surgery is relatively straightforward. When a bone is broken or cut, it grows new cells in order to seal the two halves of the bone together. This is similar to when a bone is broken and held together by a cast or pins, and it proceeds to mend itself. By keeping a slight distance between the two halves at all times and not allowing the bones to seal, the bone continues to grow, and thus it is lengthened. The tissues around the bone also respond to this stretching and work to match the increased length.

One way of accomplishing this slight tension is to insert pins into the bone on both halves, which are then attached to an external frame. This frame is rigid, holding the bone in position, but it also has keys that are turned to separate the bone halves gradually. Other methods are entirely internal, some using a telescoping nail that holds the bone apart and lengthens gradually on its own, others using an electronic device that monitors the growth and expands in response to a controller. Bone lengthening technologies are constantly improving, and many may reduce the risk of infection and complications from the surgery.

Children with limb deformities often require a surgery of this nature, but it can be performed on adults as well. Sometimes, if height is not the desired outcome, it makes more sense to shorten the longer bone rather than lengthen the short one. This is particularly the case if the difference in length is relatively small. Shortening a bone is extremely precise, though it is also a complicated surgery. Consultation with a doctor is necessary to determine the appropriate approach.

Many problems are associated with bone lengthening, though these have been lessened over time. Older technologies left weakened bones in the space that was lengthened, but it is said that distraction osteogenesis does not have this effect. In patients who previously had proportionate limbs, lengthening the legs often made the shins — where the surgery was typically conducted — look disproportionately long.

Infection when using an external frame, or even from the surgery itself, is a serious risk and may end in amputation of the limb. Extreme pain during the healing and stretching periods of this surgery is a frequently reported symptom, and as this procedure can last for more than a year for an adult, risk of addiction to pain medication may also be an issue.

Anyone who wishes to undergo bone lengthening surgery should be sure to use only a reputable doctor, even though the procedure can be expensive. The frequency and severity of complications associated with this surgery even when performed in the best possible conditions makes seeking less expensive and less reputable doctors a life-threatening decision.