Leg lengthening/shortening

Alternative names:

bone lengthening; bone shortening; correction of unequal bone length; epiphyseal arrest; epiphysiodesis; femoral lengthening; femoral shortening

Expectations after surgery:

Epiphysiodesis is usually successful when performed at the correct time in the growth period, though it may cause an undesirable short stature.

Bone(femoral) shortening may achieve more precise correction than epiphysiodesis, but requires much longer convalescence.

Bone (femoral) lengthening is completely successful only 40% of the time and has a much higher rate of complications.

Convalescence:

With epiphysiodesis (epiphyseal arrest), hospitalization up to a week is common. Occasionally a cast is placed on the leg for 3 to 4 weeks. Healing is complete in 8 to 12 weeks, at which time full activities can be resumed.

With bone (femoral) shortening, 2 to 3 weeks of hospitalization with bedrest is usual. Occasionally a cast is placed on the leg for 3 to 4 weeks. Muscle weakness is common and muscle-strengthening exercises are started soon after surgery. Crutches are used for 6 to 8 weeks. Some children require 6 to 12 months to regain normal knee control and function. The intramedullary rod is removed at 1 year.

With bone (femoral) lengthening, hospitalization lasts a week or longer. Intensive physical therapy is required to maintain normal range of motion. Frequent visits to the doctor are necessary to adjust the lengthening device. Meticulous care of the pins holding the device is essential to prevent infection. Healing time is determined by the amount of lengthening. For each centimeter of lengthening, 36 days of healing is required.