Limb lengthening surgeries are a surgical field that has been performed for nearly a hundred years and is thought to be even older. It has evolved since those years.
There are mainly three systems. The first one is an external system. The application called Ilizarov method is a system in which the bone is fixed with thin wires and rings. This device holds the bone from above and below, and after the bone is cracked, the patient slowly turns the screws on the device and lengthens the bone. This is also called the external fixation method.
The second one is the combination method which is an advanced stage. In this method, there is a fixation system outside the skin for fixing the bone, and there is a nail or plate inside the bone. The most important advantage of the combination method is that it shortens the external fixing time. The external fixation is the condition that is the most complained by the patients and disrupts the comfort of the patient. The difference from the Ilizarov method is that after the lengthening process is performed in a similar way, the bone is fixed by the nails or plates and the external fixation is terminated.
The combination system is more preferred as the people for whom a cosmetic lengthening process is performed do not generally want to walk around with an externally visible device. In the Ilizarov method, it is necessary to wait 1 to 1.5 months for every 1 centimeter to be lengthened. This means that the patient stays with the device for 5-7.5 months for a 5-centimeter lengthening. In the combined system, for example, as a lengthening of 1 mm per day on average may be achieved in an individual for whom a lengthening of totally 5 centimeters will be achieved, he/she live with the device for only 50 days, after which the external system is removed with surgery and the nail or plate remains inside the body. The combination system is more widely used as it is very comfortable for the patients.
The third method is the lengthening using the systems passing through the bone. There is no external system in this method, and there is only a nail (motorized nail) extending inside the bone. The internally applied nail can be considered as a telescopic motorized nail. The comfort level of the patient is very high as the bone lengthening is only provided with an internal system. However, it is more costly than other methods.
Pain may also occur due to the stretching of the muscles and nerves during lengthening as these treatments are performed along with the bone cracking. However, this varies from person to person. Some patients may continue their daily lives, while others may experience pain to an extent not to be able to leave their home.