Dr. Podeszwa explaning a limb lengthening case on Facebook live.

Nov 01, 2017 / Limb Lengthening

#SRHaccess Facebook LIVE Recap: Limb Lengthening

On this week’s Facebook live, Co-director of the Center for Excellence in Limb Lengthening David A. Podeszwa, M.D. joined us to discuss the process and treatment options for patients with a limb length difference. Below is recap of the conversation. 

Watch the limb lengthening Facebook live. 

What is a limb length difference?
A child whose legs are two different lengths. The most common limb length difference is for the lower extremity, however it is possible on the upper extremity.

Different causes of a limb length difference:
  • Congenital condition – the child is born with it.
  • A traumatic injury to the growth plate – breaking the thigh or leg bone.
  • Infection
What is the process for a patient with a limb length difference when they come to our hospital?
  • First and foremost, the patient will go through a detailed history and physical exam.
  • An X-ray will be taken of the entire lower extremity to measure the length of the legs and to determine any deformities. The hospital uses a machine with a significantly lower dose of radiation for this test.
  • After the X-ray, the doctor will measure the difference to determine the type of treatment.
  • Less than an inch in difference, often there is no need for treatment.
    • With a small difference, it is possible that a patient will be given an insert to wear inside their shoe to help with any pain or discomfort.
  • 1-2-inch difference – the most common treatment is to slow the growth of the longer leg so that the shorter leg can catch up in length.
Importance of monitoring a potential limb length patient:
As the child grows, our specialists follow them yearly up until the time they are done growing. A difference is identified at a young age and the length discrepancy is predicted depending on their age and growth plates.

Multidisciplinary approach:
  • A child whose limb length difference is over two inches requires a team of experts to guide the patient and their family through the six to nine-month process.
  • Working as a team: before a surgery date is set, the patient and their family meet with multiple departments within the hospital.
    • Physicians meet with fellow physicians to discuss the treatment plan.
    • Patient meets with the nursing team to discuss education regarding the procedure and what to expect.
    • Our psychology team meets with the patient and family to help them understand the treatment and how to cope with the before and after stages.
Treatment options for limb length difference of two inches or more:
  • Intramedullary rod: a rod that is surgically implanted inside the bone. The rod is magnetic and adjustments are made after the surgery, noninvasively, to lengthen the bone.  
  • External fixator: a frame (rings) that are attached to the bone surgically. This technique is used most commonly with a patient who is not only needing length, but also deformity correction. The patient can walk, be active and go to school while wearing the fixator.
Closing remarks about limb lengthening:
  • The treatment of a limb length difference is part of the child’s life, but does not run their life.
  • In the end, treating the difference is to improve the patient’s life, but not define their childhood.
Our experts are here for the patient and their family every step of the way. Have more questions about limb lengthening? Email askadoc@tsrh.org

Learn more about limb lengthening and the research our hospital is conducting. 

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