What is limb lengthening? Limb lengthening is the gradual lengthening of bones by means of an external fixation brace, which can be in the form of a ring or a unilateral strip, and is based on the principle of osteogenesis by the Russian surgeon Ilizarov, which means that any tissue, including bones, blood vessels and nerves, will regenerate and become active under tension and stress. Therefore, after amputation of the bone by slow pulling, new bone tissue will appear between the broken bones, and after the new bone is fully formed and has sufficient strength, the external fixation brace will be removed. Usually a cast is used for protection. What are the risks of limb lengthening? Limb lengthening can take up to 40 days due to the long duration of the entire procedure, typically 1 cm of bone lengthening with external fixation of the brace, so the greater the lengthening the higher the complications. Common complications include: Needle infection, pain Severe soft tissue infection as well as osteomyelitis Impaired joint mobility, subluxation Bone discontinuity, slow bone connection Emerging bone fractures Limb force line deviation, multiple surgical adjustments Should I have surgery with such high risks? Limb lengthening has been performed for over 50 years since its inception and is now widely used in the treatment of orthopedic conditions, and both the surgical technique and the surgical instruments have been greatly developed. Limb lengthening is a complex operation with high complications and requires the cooperation of the surgeon and the family as well as the child. We will carefully evaluate your child’s condition and strictly manage the entire limb lengthening process, and most of the children we have treated so far have achieved satisfactory results. In all cases, there have been no serious complications. Which children are suitable for limb lengthening? Congenital asymmetric limb development with relatively small limb on one side and limb shortening of more than 2.5 cm. Limb shortening due to trauma resulting in abnormal epiphyseal growth. In general, children with hypertrophy are suitable for temporary epiphyseal block to delay the growth of the long side limb and finally achieve limb equilibrium, but children with short height can also use limb lengthening to compensate for the height deficiency, i.e., lengthen the short side. After lengthening, the limb can achieve equal length, but there is no reliable method to treat the thickness of the limb. When is the surgery suitable? Is it possible to achieve equal limb length in one surgery Because the whole treatment process is long and requires the cooperation of children and parents, it is traditionally considered that bone lengthening is suitable for children over 6-7 years of age, however, we have found in our clinical practice that children of relatively young age have fewer complications, so it depends mainly on the degree of difference in the final limb length of the child. It is generally considered that a single lengthening should not exceed 15%, and if the final length difference is large, several lengthening sessions may be required to achieve limb equivalence.