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Limb Lengthening Deformity Correction

 
 
 
 
  LIMB LENGTHENING
 
 
10 cm shortening of the Humerus corrected with Ilizarov Limb lengthening
 
Severe shortening of humerus due to osteomyelitis High level of comfort and freedom from pain in ilizarov fixator for lengthening his humerus. Humeral lengths are almost equal due to 9 cm lengthening. Elbow flexion preserved after 9 cm humeral lengthening
 
26 yr old Chartered Accountant had severe 10 cm shortening of his Left humerus following a childhood osteomyelitis. He had had similar shortening of his Left lower limb as well for which he had successfully completed 26 cm of lengthening more than 10 years ago. 26 yr old Chartered Accountant had severe 10 cm shortening of his Left humerus following a childhood osteomyelitis. He had had similar shortening of his Left lower limb as well for which he had successfully completed 26 cm of lengthening more than 10 years ago. 26 yr old Chartered Accountant had severe 10 cm shortening of his Left humerus following a childhood osteomyelitis. He had had similar shortening of his Left lower limb as well for which he had successfully completed 26 cm of lengthening more than 10 years ago. 26 yr old Chartered Accountant had severe 10 cm shortening of his Left humerus following a childhood osteomyelitis. He had had similar shortening of his Left lower limb as well for which he had successfully completed 26 cm of lengthening more than 10 years ago.
 
8 cm Lengthening of the Femur (Thigh) bone done for growth arrest by using LON technique.
 
Shortening of femur due to growth arrest Femur Lengthening over nail done with Ilizarov external fixator. good comfort while walking Clinical result of 8 cm of femur lengthening with a straight limb Full knee ROM after 8 cm of femur lengthening
 
22 yr oldwith 10 cm shortening of femur due to growth arrest Femur is sigificantly shorter. Treatment with external fixation wold take too long to achieve the 8 cm of length needed--perhaps more than 8 months. 22 yr oldwith 10 cm shortening of femur due to growth arrest Femur is sigificantly shorter. Treatment with external fixation wold take too long to achieve the 8 cm of length needed--perhaps more than 8 months. The external fixator was removedwithin a few months and all the length was achieved. The bone hardened well and he had full retained funtion in the hip and knee joints with squatting also possible. The external fixator was removedwithin a few months and all the length was achieved. The bone hardened well and he had full retained funtion in the hip and knee joints with squatting also possible.
 
Dwarfism caused by Achondroplasia result in max. height of 3' 11". Ilizarov lengthening gave her 9" in two stages.
 
Achondroplasia is the commonest form of short limbed dwarfism. It is most amenable to lengthening and if treatment is started early, a significant amount of height can be achieved and significant social stigma associated with dwarfism can be avoided. These children do not grow more than 3'11" and tend to sufer from early Osteoarthritis due to associated bowing deformities. Cross Lengthening is one of the methods of treatment which minimizes morbidity and maximizes amount of length achieved in the smallest time period. The tibia was lengthened in a double level manner and the femur in a single level using the Ilizarov fixator. It is the best method for lengthening the tibia without deformities and the femur is easitly manageable for younger children. Second stage of cross lengthening is easier to tolerate and walking is not difficult during treatment. Total amount of height gained is 9 inches without significant complications and gives a lot of confidence and happiness. Ideally this treatment should be started very early in life.
 
12 year old child having Achondroplasia and short limbed dwarfism is hardly 3'9" tall and is likely to grow to only 3'11". She has bowing deformities in her knees and already has pain in the knees. She also suffers from difficulties in social integration Unfortunately, she was informed by a famous Paediatric Orthopaedic Surgeon that lengthening should wait unitl maturity--an advice which is frequently given due to ignorance. Since they decided to perform the entire amount of length, it was decided to perform the Cross Lengthening method. The tibia was lengthened with Double level lengthening and the opposite femur lengthened in a single level lengthening After a small break, the opposite pair is lengthened to the same extent. Walking is possible with a walker and knee bending and ankle exercises are possible. Comfort levels are reasonable and with proper nursing and modifications to the bed and help from parents, significant length can be achieved without significant pain. At the end of the two stages in which both femurs and both tibiae were lengthened to more than 22.5 cm or 9 inches she is happy and more confident of dealing with the world.
 
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DEFORMITY CORRECTION
 
severe bowing deformity due to Rickets in 37 yr. old Doctor very accurately treated by software simulation and accurate deformity correction.
 
Severe varus bowing deformity in a 37 yr old lady doctor who was misdiagnosed as having rickets when she really suffered from hereditary bowing --probably the reason why she was uncorrected for so long. Shows correction in progress with nice ability to walk with the ilizarov fixator Full correction of the deformity with a very happy patient Proof of the pudding!-- full knee ROM as well after correction of femoral deformities with Ilizarov fixator
 
37 year old lady doctor suffered from severe bowing deformities due to hereditary bowing deformities . She was misdiagnosed as having resistant renal rickets and hence could not get adequate treatment for this long. The ilizarov fixator allows full movement and walking. Shows full correction of the deformities and a very nice correction. The full length x-ray also shows the full correciton with the mechanical axes passing within the centre of both knees. Finally, it shows the knee bending fully and allowing full function. Shows full correction of the deformities and a very nice correction. The full length x-ray also shows the full correciton with the mechanical axes passing within the centre of both knees. Finally, it shows the knee bending fully and allowing full function.
 
Precise correction of Knock-knee (valgus) deformity with great accuracy
 
Severe valgus knock-knee deformities in a 33 year old who had early arthritis and pain in knees Correction of Left tibial valgus with the Taylor's Spatial frame fixator with accurate correction Right side now fully corrected with Orthofix fixator in the femur and the Taylor's Spatial Frame fixator in the tibia Accurately corrected valgus deformity showing normal alignment of the lower limbs and straight limbs
 
33 year old lady from Sweden had a 14° valgus knock-knee deformity. The mechanical axis was deviated outside causing her pain and arthritis. We used the Taylor's Spatial Frame for the tibia and an Orthofix fixator. After surgeries, her legs have become completely straight.
 
The deformity was analysed as being 7° of valgus each in the femur and tibia. The mechanical axis passed significantly on the outer aspect of the knee denoting tremendous pressure on the outer compartment--which explains her pain and arthritis.

Surgeons in Sweden refused to treat her as the deformity was "too small". On correcting this deformity, if there is an error of correction of 1° it would be an error of almost 15% and an error of 2° would be almost 30% error in each segment.

Hence what she needed was Precise deformity correction in all her four segments--both thighs and both legs.		 Hence we chose to perform this using external fixation--the Taylor's Spatial Frame for the tibia and an Orthofix fixator for her femur for greater comfort. Initially the Left was corrected accurately and we can see that the leg appears straight and the mechanical axis on the x-ray now passing thru the centre of the knee similar treatment was done next on the Right side with an equally accurate correction. Finally after surgeries, her legs have become completely straight and the full length xrays show good correction with the mechanical axis passing exactly through the centre of her knee joints.
 
Dr. Milind Chaudhary,
Consultant Orthopaedic Surgeon
having the largest experience in India in this
field conducts this speciality OPD on Saturdays
(by prior appt. only.)
 
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