Treatment to Maximize Function and Minimize Negative Impact
Experience with the latest technology, devices and surgical techniques enables us to give you the very best options for your children. At the International Limb Lengthening Center some conditions can be treated with simple one time operations and others require staged procedures. Whatever the case, from the time of your first consultation with the International Limb Lengthening Center, it is our goal to discuss various options for treatment and answer all your questions in order to help you make the best decision for your child.
For cases involving complex limb deformities and length discrepancies in children, growth and limb length calculations are made to predict height, limb length discrepancy and progression of deformity in order to inform parents of expectations and proactively treat growing children. For these more complex cases, options will be outlined for a life plan and the ideal ages at which various stages of reconstruction can be performed in order to maximize function and minimize any negative impact on family, childhood, school and life pursuits.
Conditions We Treat
- Blount’s disease/tibia vara
- Bone deficit
- Congenital femoral deficiency/proximal focal femoral deficiency
- Congenital pseudarthrosis of the tibia
- Fibrous dysplasia
- Fibular hemimelia
- Growth plate/physeal arrest
- Hip dysplasia and impingement
- Legg-Calve-Perthes disease
- Limb length discrepancy
- Osteochondromas/Multiple hereditary exostoses
- Slipped capital femoral epiphysis
- Skeletal dysplasias
- Other limb deformity
- Limb lengthening
- Precice nail
- Fixator assisted nailing/plating
- Taylor spatial frame and Orthofix TL Hex
- Ilizarov reconstruction
- Bone transport
- Periacetabular osteotomy/PAO
- Joint distraction
- Triple pelvic osteotomy
- Guided growth/8 Plates
- Superhip, Superknee, and Superankle procedures
- Stature lengthening
I am thankful because now I am a new person.Laudy Matos
Orthopaedic Patient, Dominican Republic
How It Works
EOS Imaging uses slit scanning technology to create radiographic images with almost 90 percent less radiation than traditional x-ray. The scanner works by moving a thin slice x-ray beam down the axis of the patient over several seconds. This has several advantages, most notably the accuracy of measurements that we can make on spine and full leg length lower extremity x-rays. A normal x-ray is a snapshot much like you would take with a smartphone or other camera.
Depending on the size of the patient, distance of the bone to the x-ray cassette and distance of the beam from the patient various amounts of magnification are introduced into a the images. With EOS there is no magnification and all measurements are made on our digital system with exact precision. An additional benefit is that the scanner images both the frontal and side views simultaneously which is not only fast, but also allows for reconstruction of three dimensional imagery. We were one of the first centers on the west coast to have this technology and continue to be one of the few institutions that have this available.
Limb lengthening is not typically performed during an operation, rather the operation at the International Limb Lengthening Center is performed to enable distraction osteogenesis which is the growth of new bone that occurs when bone is stabilized, divided and then slowly distracted over time. The growth of bone occurs quite predictably and there are no objective limitations on how much a bone can be lengthened. One of the biggest challenges with bone lengthening is accommodating skin, nerves, vessels, tendons, muscles and other soft tissues which must lengthen as well. This is where the importance of physical therapy comes in.
What to Expect
Depending on the bone lengthened, the cause of the condition, and the amount of length needed, various physical therapy protocols are prescribed after surgery. The most intense protocols require physical therapy five days per week which we require to be performed by our expert physical therapists at Loma Linda University Health. Without appropriate therapy, joint contractures and dislocations can occur which can negate all the benefits of this type of surgery if not recognized and treated proactively.
Our therapists are specifically trained in protocols involving Ilizarov reconstruction, Precice nail lengthenings, and Taylor Spatial Frame cases. We follow the protocols established at the Paley Institute where our therapists have completed training courses. For some cases it is appropriate and more convenient to have physical therapy at other locations for geographic and/or insurance reasons. In any case direct communication with therapists and the surgeon is essential for optimizing the results of lengthening surgery.
Orthotics and Prosthetics
We are fortunate to have our location adjacent to the Orthotics and Prosthetics Lab and School of Orthotics and Prosthetics at Loma Linda University Health. Each department uses innovative technologies to provide our patients with state of the art orthotic and prosthetic devices. Their enthusiasm for treating people with limb deficiencies and other disabilities is exemplified by the incredible athletic accomplishments attained by many of the patients they treat.