Leg Lengthening

Leg lengthening is carried out where there is a difference in leg length either from birth or arising as a result of an accident. The aim is to equalise the lengths of the legs. Legs are often lengthened together with a correction of deformity.

Whilst leg lengthening used to be carried out via frames and devices attached to the skin (external fixator), treatment was revolutionised by the development of extension nails. With these, the extension device is inserted into the bone and is not visible from the outside. The device has a small magnet motor. When the motor is activated by an external remote control (ERC), the device lengthens slowly, which in turn lengthens the bone.

Despite this modern treatment method, leg lengthening is a very complex undertaking. A good outcome requires many years of experience of operations, intensive aftercare and careful rehabilitation.  Leg-lengthening should therefore only be carried out by a specialist. Dr. Klotz has been carrying out leg lengthening for many years with a high number of cases. He will provide comprehensive advice in his surgeries in Vienna and Linz.

The two stages of leg-lengthening 

The extension is split into two stages: Distraction and Consolidation. The extension itself takes place in the stage known as Distraction. After the desired length is reached, the newly re-generated bone is still very weak. The hardening and regeneration of this bone is designated the consolidation phase.

Modern nails mean that is it nonetheless possible to put weight on the leg that has been operated on immediately after surgery. The type of load bearing depends on the body weight of the patient and the thickness of the nail. In most cases, however, full weight-bearing is possible.

The Precice System 

The Precice Leg Extension System (NuVasive Specialized Orthopaedics, San Diego, CA) consists of a surgical stainless steel extension nail with integrated magnet motor. The nail is inserted into the bone canal through a small incision.

The patient receives a special remote control with which the Precice nail is gradually lengthened.  In the remote control, there is a small magnet. When the remote control is places on the arm or the leg and switched on, the extension nail, and with it the bone, are stretched. The extension itself is so slow that the patient feels no pain. This is one of the most important advantages compared with other systems.

The system is normally removed after 18 months.

Dr. Klotz has many years of experience of leg extensions and is regarded as an experienced specialist in this area. This treatment routine is essential in the most challenging circumstances.

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