Limb Lengthening Surgery in India: How Does it Work?

In our ever-evolving world, the pursuit of self-improvement and the desire to overcome physical limitations have become inherent traits of human nature. While we embrace our unique qualities, there are times when we yearn for a transformative change, especially when it comes to our physical stature. This is where the remarkable field of limb-lengthening surgery comes into play.

Limb lengthening surgery has emerged as a groundbreaking solution for those who have dreamt of adding a few inches to their height or regaining lost limb length due to injury or congenital conditions. In recent years, India has become a global hub for this transformative procedure, offering cutting-edge technology, world-class medical facilities, and highly skilled surgeons.

Limb lengthening, a rapidly developing field of orthopedic surgery, is a standard procedure with predictable results. Indications have been extended to include cosmetic lengthening and upper extremities.

Limb lengthening remains a significant challenge for the patient and the orthopedic surgeon. While the surgical procedure isn't complicated, the postoperative recovery can be long and demanding, potentially jeopardizing the initial positive outcome.

Limb Lengthening surgery costs USD 2070 to USD 2530 in India.

What is Limb Lengthening Surgery?

Limb lengthening, a surgical procedure, reduces/corrects limb-length discrepancies. 

A limb-length discrepancy can be in the following cases:

• When one arm or leg is shorter than the other arm or leg 
• If children are born with congenital limb differences that cause their arms or legs to grow at different rates. 
• Limb-length discrepancies caused by serious fractures, fractures that do not heal properly, bone infections such as osteomyelitis, or bone tumors or cysts.

Watch below the successful story of Ndubisi Chidimma Lilian from Nigeria, who received limb lengthening surgery in India after a terrible accident:

How Does Limb Lengthening Work?

Limb lengthening takes advantage of the body's natural ability to create new bones. The process occurs in three stages: surgery, distraction, and consolidation.

Surgery

• A surgeon cuts the bone (osteotomy) to be lengthened, which is performed specifically to preserve blood flow and other biological processes that help bones heal. 
• After cutting the bone, the surgeon attaches a lengthening device to the limb. 
• The device is used to create a gap in the bone during the next stage.

Patients typically stay in the hospital for at least one night after this procedure. The second stage typically begins after their limb has had a week to 10 days of rest.

Distraction (lengthening)

• During the second stage, the two ends of the bone are gradually separated, stimulating the new bone to grow and filling in the gap created during the lengthening. 
• This stage typically takes up to two months.
• The surgeon or another clinical team member teaches the family members to lengthen the device a small amount several times a day. 
• After that, a family member or the patient will lengthen the device at home.

The surgical team will carefully monitor the bone and surrounding muscles, tissues, and nerves throughout this stage. If they see any sign of possible complications, they may pause the process or change how slowly or quickly the bone is being lengthened.

Consolidation (healing)

• Once the limb has reached its planned length, the body's natural healing process continues to fill the gap with new bone. 
• Meanwhile, the nerves, muscles, tendons, and ligaments around the bone adjust to the new length.

Physical or occupational therapy during the second and third stages is essential to maintain joint and muscle mobility around the lengthening bone.

Watch the successful story of limb-lengthening surgery performed in India here.

Types of Devices Used for Limb-Lengthening Surgery

Limbs can be lengthened with an external frame or an internal lengthening rod. Before the surgery, your family and your surgeon will decide which device will work best for you.

External Fixators 

These are worn outside of the arm or leg. Some external fixators go around the limb, while others run parallel to the limb. Both types are attached to the bone by pins and lengthened with a small, hand-held tool. External devices are typically removed after consolidation when the new bone is strong enough to bear weight.

Internal Lengthening Rods (PRECICE Nail) 

These are implanted inside the bone. They are lengthened with a magnetic device that causes the rod to expand. Internal devices are typically removed one year after being inserted into the bone. While removing the rod requires anesthesia, most patients return home the same day it is removed.

What are the Advantages of Limb Lengthening Surgery?

Limb lengthening surgery can make your bones longer if you have bone discrepancies, bone growth abnormalities, or shorter bones due to skeletal dysplasia. Having limbs the proper length can improve your:

• Range of motion
• Gait (walking stride)
• Strength
• Flexibility
• Complications of leg length discrepancies, like problems with posture or pain in the back, hips, knees, or ankles

How Much Can Each Bone Be Lengthened?

During each lengthening treatment, a bone is usually extended by no more than 2 inches (5 cm). If lengthening is done on both the femur (thigh bone) and tibia (shin bone) simultaneously, a total of 4 inches can be achieved (2 inches in each bone).

In severe cases, greater lengthening may be possible during one treatment. For example, children and adults with large lengthening goals may tolerate over 2 inches of lengthening in each bone. To maximize the length, some children have three lengthening treatments before they are 16. This is often combined with other procedures, such as deformity correction, epiphysiodesis, etc.

Is Limb Lengthening Surgery Risky?

As with any surgery, there are some risks associated with limb lengthening. Discussing these risks with your surgeon is important to determine whether limb lengthening is right for you. 

Possible complications may include:

• Patients are at a risk of developing blood clots post-surgery.
• In some cases, nerves and blood vessels can become damaged during surgery or the bone's subsequent lengthening.
• As with any surgery, there is a risk of infection. The risk of infection is low with a PRECICE device, while the risk slightly increases with an external fixator.
• As the bone is lengthened, your soft tissues also get stretched. Muscles become very tight, and you must maintain movement in your hips, knees, and ankles. 
• Post long lengthening procedures, there is a small risk of dislocation of a nearby joint.
• A delayed union may occur if the bone does not form during lengthening or takes a long time to consolidate. 
• Following the removal of the device, there is a small risk of fractures in the lengthened bone. 

Leading Doctors in India Performing Limb-Lengthening Surgery

• Dr. Prithvi Mohandas: He is a recognized Orthopedic Specialist with over 20 years of experience. He collaborated with the Hospital for Special Surgery, New York, in determining the variables that affect hip implant design, the effect of load transfer in the femoral head, and minimally invasive surgery.
• Dr. Jayant Arora: He is a notable Orthopedecian & Joint Replacement Surgeon with over 20 years of experience. He is a world-renowned figure in Total Knee Replacement and Partial Knee Replacement using Computer navigation and Robotic surgery. 
• Dr. Atul Mishra: He is a well-known Orthopedician having over 23 years of experience. He performs about 1000-1200 knee replacements & arthroscopies in a year.
• Dr. Ashok Rajgopal: He is one of India's most experienced Orthopaedic Surgeons, with over 32 years of experience. He has a groundbreaking record of completing 25,000 Total Knee Replacement surgeries.
• Dr. S. K. S. Marya: He has been in Medicine and Orthopaedic Surgery for over 30 years. His areas of specialization include Joint Replacement Surgery for the joints of upper and lower limbs (Primary and Revision) and Trauma Management based on AO Principles. 

Key Takeaway

Limb-lengthening surgery in India has emerged as a ray of hope for individuals seeking to overcome physical limitations and unlock new heights. This procedure has transformed countless patients' lives and positioned India as a global leader in medical innovation and healthcare excellence. India's rise as a preferred destination for limb lengthening surgery can be attributed to its state-of-the-art medical facilities, cutting-edge technology, and a pool of highly skilled and experienced specialists. 

It is crucial to emphasize that, like any other surgical intervention, limb lengthening surgery also requires careful consideration, consultation with medical professionals, and a thorough understanding of the procedure. It is essential to carefully consider surgery's risks and possible complications, even though the potential benefits can be life-changing.