This operative technique for limb lengthening is based upon the controlled distraction of callus following osteotomy.
The patient may be any age. The optimum site for osteotomy is the metaphysis since this has a relatively high concentration of active osteoblasts able to form new bone when suitably stimulated. Alternatively, lengthening through the open physis may be performed but should be reserved for patients whom have ceased growing as this approach precludes any further natural growth.
Technique is important:
- avoid misplacing pins into the joint or across the epiphysis
- minimise amount of soft tissue dissection since this might result in devitalisation of the bone
- leave the medulla intact if possible when drilling through the cortex
- distract once callus forms - after about 10 days - aim for a rate of 0.25 mm, four times daily
- review by x-ray every 4 weeks to ensure continuity of callus between bone ends
Last reviewed 01/2018