Lengthening

Lengthening is the term given to the surgical elongation of the bone. Here we apply the ring fixator or LRS to the affected bone and then do a corticotomy (making a fracture surgically at the bone where we want to do bone lengthening) The causes of bone shortening are Congenital, traumatic, post traumatic shortening, Post infective, developmental, growth plate abnormalities and stature lengthening (cosmetic lengthening). Mainly in all the countries Ilizarov or LRS is used in bone lengthening. Using the above implants, we are doing gradual lengthening. Gradual lengthening is the process where the bone is cut and the cut ends of the bone are pulled apart (called distraction), using an external device called external fixator or an internal device like nail (ISKD- Intra-Medullary Skeletal Kinetic Distractor). When there is a discrepancy in the limb length, it is advisable to correct the discrepancy at the earliest instance. A neglected limb length discrepancy leads to an awkward gait, Compensatory deformities can develop, early knee joint arthritis, back pain, spondylosis & deformities of spine. Fixator is not the only method used for lengthening of bone, to reduce the fixator time other methods like – LON (lengthening over nail) LOP (lengthening over plate & LATN (lengthening and then nailing) are also available. In Lengthening over Nail i.e. bone lengthening done over an intramedullary nail, an intramedullary nail is inserted in the bone; an external fixator is also applied; the bone is cut and distraction is done using the fixator while the nail is still inside the medullary canal – that is why the name lengthening over nail. Once the distraction is over the nail is locked and the fixator can then be removed. Lengthening and then Nailing is the procedure where an external fixator is applied; the bone is cut and distraction is done. Once distraction is completed another surgery is done in which an intramedullary nail is inserted and the fixator removed.