Length discrepancies of arms or legs are very common, for most people this will not cause any
discomfort. A small length difference of, for example 1 cm, is often not noticed by a person. The
human body will compensate such a disbalance by tilt of the pelvis and/or compromised gait when
walking. However, a length difference of more than 2 cm may cause complaints and health problems.
Short legs in general ,within a further healthy person, may also cause aesthetic discomfort, in which
bi-lateral lengthening may be considered. The limb lengthening procedure is offered in Dubai by
American Academy of Cosmetic Surgery Hospital (AACSH) by a highly experienced orthopedic
surgeon.

What is Limb Length Discrepancy?

Limb lengthening discrepancy is a difference in length of an arm, or leg, between the left and right
side. Such a discrepancy may be solved by surgical intervention.

Diagnosis

Diagnosis will be established through physical examination by the orthopedic surgeon, evaluation of walking pattern and X-ray images

Possible Causes

Very often length discrepancies occur by nature, in other words are genetic. This can be detected by
a medical professional during youth. Also, during development of the body in children, the growth
disc may not function well, due to disease or external causes such as trauma. Within adult population
leg length discrepancies are often caused by trauma, such as traffic accidents or job related
accidents. Fractured bone sometimes heals in mal-alignment or in a shortened position. In rare
occasions specific diseases may be cause of length discrepancies such as rachitis, metabolic
abnormalities or skeletal dysplasia.

Signs and Symptoms

Limb length discrepancy may cause several complaints. This can vary from feeling tired easily, to pain
in the back, hip, knee and/or foot. Also, deviations in gait (walking pattern) my occur. Sometimes the
right diagnosis is made in a late stage due to focus on a local complaint (knee, or hip for example)
instead of evaluating the overall posture by X-ray image. A shortened arm may lead to difficulties in
activities of daily life. Furthermore, short limbs may lead to discomfort for aesthetic reasons.

How does the Procedure work?

The surgeon cuts the bone of the shortened leg or arm and implants an adjustable nail. Elongation of
the bone is established through an electro-magnetic field that activates the mechanism inside the
nail, facilitating a very precise movement.
First elongations will be performed at the clinic, this is mostly pain free and without any discomfort.
The patient may be instructed, solely by judgement of the doctor, to proceed with following
elongation at home. The patient will be instructed thoroughly in that case by a technical assistant.
The device which activates the electromotor inside the nail, will be loaned to the patient in that case
for the needed period of time (see picture).


Elongation of the bone will be about 1 mm per day, in three sessions. However, this may vary. This
means that (for example) for a lengthening of 4 cm, 40 days of lengthening is needed. The patient
needs to protect the implant by partial weight bearing, meaning that during the lengthening period
(and some time past this period) the patient needs to use crutches.


Image: X-ray photo length correction right leg; before, after surgery, and end result.

After the lengthening period, the bone needs to heal for a couple of months before regaining its
original strength. The implant can be removed (most of the times) after 1 year by minor surgery.

Who needs Limb Lengthening Surgery?

Adults that have a leg length discrepancy (left versus right) of more than 2cm. Adults that suffer from
angulated bones in combination with length discrepancy due to trauma (accidents). Adults that seek
lengthening of both legs for aesthetic reasons. Children that suffer from leg length discrepancy, by
cause of trauma or disease or from genetic cause.

Consult your Orthopedic Surgeon for Treatment Options

Before you undergo a limb lengthening treatment, you must consult your orthopedic surgeon. You
must present all your medical history records and the list of medications you are taking and have
taken in the past. The surgeon will guide you in your preparation for the surgery.

Preparing Before Surgery

Before the surgery, you must consider certain preparation. You must follow a healthy diet and
lifestyle. You must take proper medication to bring your body parameters like blood pressure and
blood sugar level to normal values. If you have any bad habits like smoking, you should quit this.

You Should Know

Here are certain facts that you should know about limb lengthening surgery:

• Surgery Duration

o The duration of the surgery is about 1,5 hours (one bone) but will depend on every
specific situation.

• Recovery Time

o The recovery time for the patient depends on the general health condition of the
patient. The healing process is fastened in the presence of good health. One day
after surgery the bone will be observed by the doctor with use of X-ray photo’s and
this will be repeated at 6 weeks. Two weeks after surgery the wound will be checked
by a doctor.

• Anesthesia

o The surgeon decides whether to choose local or general anesthesia depending on
the patient’s health condition, resistance power, and neurological condition.

• Stay in Hospital

o After the surgery, the surgeon prefers to monitor the health of the patient. For that
reason patients need to stay in the hospital after the surgery. Common stay following
limb lengthening surgery is 3-7 days.

Expectations after Surgery

Aim of treatment is to diminish leg length discrepancy and decrease associated complaints. Also, aim
may be to restore limb length of both legs to improving quality of life. Optimal recovery requires a
rehabilitation program and therefore will take some time.

Risk Factors

Like any other surgery, an limb lenght surgery has certain risk. The surgery can be associated by
bleeding, infection and other effects. Always consult your doctor when;
• The wound starts leeking.
• The wound feels hot, swollen or extreme painful.
• Patient develops fever over 38,5 C.

Costs of Limb Lengthening Procedure

Please consult American Academy of Cosmetic Surgery Hospital (AACSH)