What are the Risks of Leg Lengthening Surgery?

As with any surgery, there are some risks associated with leg-lengthening, and it’s important to discuss these risks with your surgeon to determine whether leg lengthening is right for you. Possible complications include:

  • Blood clots – Patients are at risk for developing blood clots after orthopedic surgery, but there are measures in place at the hospital to help avoid this.
  • Nerve and blood vessel injury – In some instances, nerves and blood vessels can become damaged, either at the time of surgery or during the subsequent lengthening of the bone.
  • Infection – As with any surgery, there is a risk of infection. Since the PRECICE device is inserted inside your bone, the risk of infection is very low, approximately < 1%. If you have had a previous lengthening with an external fixator, the infection risk is slightly higher. Your surgeon can discuss this with you.
  • Joint stiffness and soft tissue tightness – As your bone is lengthened, your soft tissues also get stretched. Muscles become very tight, and it is recommended you maintain movement in your hips, knees, and ankles. Physical therapists can teach you exercises to help minimize stiffness.
  • Joint instability – Following long lengthening procedures, there is a small risk of dislocation of a nearby joint.
  • Delayed union – This may occur if the bone does not form during lengthening or takes a long time to consolidate. Other reasons for failure to gain length relate to problems with stretching the nerves, blood vessels, muscles, and tendons.
  • Refracture – Following removal of the device, there is a small risk of fractures in the lengthened bone. If this occurs, the leg might require another surgery or time in a cast or brace; therefore, it is important to follow your surgeon’s recommendations about physical activities.

While a small leg length discrepancy may not cause problems, a significant difference can cause a noticeable limp and may require treatment. Non-surgical treatment options include the “wait-and-see” approach for those who are still growing and the shoe lift for those with a difference of less than 5 cm.

Surgical treatment options are generally used for leg length discrepancies greater than 5 cm.

  • Bone growth restriction (epiphysiodesis, or growth arrest) is often successful when performed at the right time in adolescence, but it may cause short stature.
  • Bone shortening is more predictable than epiphysiodesis, but it has a much longer recovery period.
  • Leg lengthening surgery may allow patients to achieve their full height potential, but external fixators require continual maintenance. Internal fixators produce comparable results with fewer risks.

Some leg length discrepancies may require special treatment, but you and your surgeon can decide what treatment, if any, is best for you.
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