Limb Lengthening & leg length discrepancy
Restoring structural balance and symmetry using magnetic nails and computerized hexapods.
What is Limb Length Discrepancy?
Limb Length Discrepancy (LLD) is a condition where one arm or leg is noticeably shorter than the other. In the lower limbs, a difference of more than 1.5–2 cm can trigger compensatory gaits, pelvic tilt, chronic lower back pain, and premature arthritis in the joints.
Who Needs Treatment?
Children and adults born with congenital discrepancies (such as congenital femoral deficiency or fibular hemimelia), or those who develop shortening following pediatric growth plate trauma, infections, or severe fractures.
Common Indicators & Symptoms
- Pronounced limp (gait asymmetry)
- Frequent back or hip pain due to pelvic tilting
- Uneven shoulder heights
- Compensatory walking on tiptoes on the shorter side
Advanced Assessment & Imaging
We use standing long-leg mechanical axis radiographs (EOS or full-leg scans) to map precise bone measurements. Alignment calculation measures the mechanical axis deviation (MAD) to assess joint loads.
Treatment Options
Two major modern methodologies are used: 1. Computerized Hexapod External Fixators (TSF, Ortho-SUV frame): Gradual adjustment controlled by patient-entered software programs. 2. Lengthening Over Nail (LON): Combines an external fixator with an internal intramedullary nail. The external frame is used for the gradual lengthening phase, and once target length is reached, the nail is locked and the external fixator is removed, significantly shortening the time spent in the external frame.
Technology & Specialized Equipment
Intramedullary magnetic lengthening nails (PRECICE), computerized hexaxial frames (Ortho-SUV and Taylor Spatial Frame), and specialized intraoperative locking plates.
Recovery & Post-Operative Care
The process involves a distraction phase (bone grows at 1mm per day) followed by a consolidation phase. Physical therapy begins immediately on day one, focusing on joint range-of-motion and muscle strengthening.
Common Questions
Research References & Publications
Elsheikh AA, Wright J, Stoddart MT, et al. (2022) Use of the Pixel Value Ratio Following Intramedullary Limb Lengthening. Strategies Trauma Limb Reconstr.