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Thursday, 25.04.2019, 00:51
Main » Traumatology » Lengthening of the lower extremities 
Lengthening of the lower extremities

Lengthening of the lower extremities

Human growth continues up to 18-20 years. After that, expect a spontaneous increase in the length of the tubular bones of the limbs and the associated growth to occur.

The shortening of the lower limbs is of two kinds:
  • true shortening, which reduced the length of the bones and soft tissues
  • relative shortening.

The relative shortening of the leg is most often caused by disease:

  • brought polio
  • dysplastic disease of bones and joints
  • Post-traumatic changes in the form of improperly fused fractures, joint contractures, subluxations in the joints.

Can be shortened both legs or one of them. The shortening of one leg arises as a consequence of injuries and diseases. Encountered congenital hypoplasia of one of the lower extremities. It is now proposed a huge number of ways to lengthen the limb and to increase growth through the most incredible sets of exercises in combination with additional methods of exposure.

But in fact, lengthen the legs can only be as a result of surgery. The operation is performed by shortening of both legs. with surgery performed on two identical segments from both sides: on both hips or both legs. Operation and on his thigh, and leg on one side is not made.

Possibilities of surgical treatment is also not unlimited. Lengthen the leg can be 5-6 cm, hips - up to 10 cm shortening of one limb surgery performed on one of its segments. Shortening of one limb is usually an indication for surgical treatment. Elongation of both limbs in the overwhelming case is cosmetic surgery and is performed at the request of the patient. The exception is the marked imbalance of the trunk and extremities, leading to lower quality of life.

To perform the surgery using the Ilizarov apparatus - an apparatus for external fixation-spoke, a rod, a spoke-Rod. The method is called the compression-distraction osteosynthesis by Ilizarov and based on the law, open the Ilizarov which states that under tension the bone and surrounding soft tissues, the resulting stress stimulates the regeneration and growth of bone tissue.

Methods of operation. In order to lengthen the bone might need to cut it, that is, osteotomy is performed. On the thigh bone is cut by one - the femur, the tibia - the two bones: the tibia and fibula. Skin and soft tissue in the thigh or leg cut. Bone dissect. The resulting bone fragments fixed needles or rods. They carried through the skin and soft tissue on both sides of the cut bone and fixed in a special apparatus for external fixation - the Ilizarov apparatus. Apparatus for drumsticks and thighs are of different sizes. With the device, which can be adjusted gradually stretch the bone fragments. This stretching is called distraction.

At night the dissected bones stretched by 1 mm. It is produced in four stages by twisting tension regulating nut. First it performs a doctor, then this simple operation the patient develops and executes its own. The time required for the necessary tension, calculated in accordance with the rate of expansion (1 mm per day). Accelerate the process of stretching the bones can not, or can not be guaranteed the effectiveness of treatment and significantly increases the risk of complications. For the treatment of bone repair processes occur. A zone of regeneration, which stretch as far as the bone is gradually lengthened. But the degree of elongation of the regenerating zone is not infinite.

Lengthening of the lower extremities lengthy process. Depending on the desired extension of treatment time can be up to one year. During the period of wearing the device for external fixation patient must walk with crutches for short distances. The spokes and rods apparatus pass through the skin, soft tissue, bone, come to the surface and attached to the unit. Exit site of the spokes of the skin must be kept clean and care for them. Processing is used antiseptic solutions and dressings. Sometimes near the spokes infectious complications arise that require special treatment. Occasionally found enough serious complication --spoke osteomyelitis - an inflammation of bone tissue penetration of infection by the spokes. This complication requires urgent medical treatment and often leads to the need to remove the device.

The process of limb lengthening can be painful. Sometimes the pain can be very strong. In this case it is necessary to use painkillers. But in general, wearing the device does not cause significant discomfort and considerable pain. After reaching the planned degree of stretching, ie, at the end of the period of distraction, there began a period of fixation, which is twice the length of the previous one. This period is necessary to strengthen the structure formed bone tissue. Consequently, the tensile thigh is 100 mm (10 cm) is required at least 100 200 days of treatment, ie For 10 months. After removal of the device the patient required more rehabilitation treatment, including exercise therapy, physiotherapy. Rehabilitation period can be up to four months.

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