Frequently Asked Questions

Doctor, may I ask how long do I have to stay in the hospital for the limb lengthening procedure?

The limb lenthening procedure has 2 distinctive hospital stays:
- The first time: For external fixation frame surgery, this hospital stay lasts for 7-10 days. The patient then will be discharged and receive outpatient treatment of stretching under the doctor's instruction.
During the outpatient treament period, the patient will self-operate the fixators to stretch with the speed of 1mm per day. An X-Ray scan is required every 4 weeks to monitor the cavities.
- The second time: When the desired length has been reached, the doctor will make an appointment for the removal of the external fixator frames. This hospital stay lasts for 2-3 days.

During the lengthening procedure, do I have to lie in bed all the time?

A few days after the surgery, the patient can sit up to have meals, perform daily duties and move his/her surgical legs. During the outpatient treatment period, the patient can stretch on his/her own under the doctor's instruction, do leg elevation exercises, knee flexion and standing exercises.

After the lengthening, will my legs get weak?

Limb lengthening does not in fact affect the life expectancy of the surgical patients like many might mistakenly believe. However, after the process, the soft tissues (tendons, muscles, nerves, blood vessels, and ligaments) cannot keep up with the new situation right away. Therefore, rehabilitation exercises are recommended for a while, the duration will depend on the natural disposition of the body and specific desired length. When the muscles, bones and joints have been stable and had good exercise and the lengthened limbs are healthy, the patient can walk, jump, dance, and return to normal life.

When do I need to undergo Achilles tendon lengthening?

Achilles tendon lengthening is usually indicated when the legs are overstretched (over 6-7cm for women and over 7-8cm for men) or during the lengthening procedure, the patient did not do any exercises or were scared to get hurt that he did not take any rehabilitation excercises.
Depending on the level of tendon contracture, the doctor will decide whether to perform this procedure or not. The Achilles tendon lengthening procedure is simple to perform. After 6 week since the surgery, the patient can walk with heels touching the ground normally.

Can the lengthening duration be shortened by increasing the daily lengthening rate?

It is absolutely forbidden to increase the daily lengthening rate.
Based on scientific and pratical researches in limb lengthening, the 1mm-per-day lengthening rate is suitable for the human body to adapt to the tension of the tendons, nerves and blood vessels. If the rate is more than 1mm per day and is applied for a long period of time, it will result in strained tendons (heels unable to touch the ground while standing) and other complications.

When can I undergo the limb lengthening procedure?

The age of 18 to 35 is the best period to undergo limb lengthening, as the person's height has stopped increasing at that age. At this age range, the legs can be lengthened by 6-7cm or even more. After the age of 35, the bones start to get old, thus it is unsuitable to perform any prolonged procedure. Customers over 35 years old need to meet the doctor in person to receive evaluation.

When the intramedullary nail is still implanted, can I have a baby?

During the lengthening procedure, with the external fixator frames still intact, you cannot have a baby as X-Ray scans will affect your unborn child.
From 8-9 months after the removal of the fixators, when the legs can function normally and your daily life is restored, you can get pregnant. The intramedullary nail does not affect pregnancy (if X-Ray scans are not required).

What are the complications that can happen during the lengthening procedure?

Limb lengthening procedure can lead to 2 groups of possible complications:
- Early complications: Complications that can be developed during the surgery or post-operative. One of these is infection. There is a very low risk of infection during surgery as all operating rooms and surgical tools are sterile. Another early complication is post-operative bleeding. At the moment, the incisions are very small with a width of 1.5cm, therefore there is little to none post-operative bleeding.
- Late complications:
Achilles tendon contracture: During the lengthening process, if the patient does not exercise, when the bones have reached the desired length, the Achilles tendons will not be able to keep up which leads to tendon contracture. The solution for this complication is to perform Achilles tendon stretch exercises during the lengthening process to stretch out the tendon.
Slow bone growth: In order for the bone to get as strong as its normal state, the average lengthening rate for the bone is at 35-45 days per cm. For some cases, it would take longer than 45 days per cm. This is not too worrisome, as the patient can wait for the bone to grow normally. Additionally, slow bone growth is also a result of age. The older the age, the slower the bone growth would get. Overstretching is another reason that leads to slow bone growth. If the length raised is 6-7cm, this complication will not likely appear. However, if the desired lengthening is over 8cm, the risk of complication will be higher.

Which cases are not allowed to undergo limb lengthening surgery?

- People with bone and joint diseases, slow bone growth and bone tumors.
- People with chronic systemic diseases: diabetes, cardiovascular diseases, asthma and tuberculosis.
- People with deformed tibia that does not allow intramedullary nailing.
- People with mental illnesses that are uncooperative and unmonitored.




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