What Is a Bone Length Discrepancy?
Our service is dedicated to correcting limb length discrepancies through bone regeneration. A limb length discrepancy (LLD) is defined as one arm or leg shorter in length than the other. It can affect the entire limb or just part of it. LLDs are very common, and many people have a small difference in leg or arm length that they don’t even notice and doesn’t need treatment. However, as discrepancy increases over 1cm or ½ in, it becomes increasingly problematic, especially in the legs. Unequal leg lengths can lead to pain in the low back, hips and knees, and correction is generally recommended.
How Are Bones Lengthened?
Bone lengthening starts with a controlled break in the bone, which is then slowly pulled apart, allowing the bone to partially heal as it gets longer. When the final distance is reached and the bone fully heals, the limb is longer and made of the same bone as the rest of the body. Pulling the bone apart can be achieved with external devices, like ringed external fixators or simple linear rails, or with internal lengthening nails. While multiple lengthening nails exist, we primarily use a magnetically driven device called the Precice nail.
What is The Precice Nail?
The Precice nail is a telescopic metal rod with a gear system and magnet that’s inserted into the center of the bone during surgery. The bone is divided by an osteotomy, and the nail is secured in place with screws. After surgery, a patient is given a handheld External Remote Controller (ERC) that has a rotating magnet inside. The ERC can be used to slowly lengthen the nail by making the magnet spin. The ERC is customizable to each patient’s needs and can be used at home.
How Much Additional Length Can Be Achieved?
The Precice nail can be used to lengthen the femur, tibia, or humerus up to 8 centimeters (lengthening the forearm still requires external fixation). Lengthening surgery with internal expandable nails is considered accurate, safe, and more comfortable for patients than external fixation methods. It has a low complication rate and high patient satisfaction rate.
Femur Lengthening Before and After Images
Tibia Lengthening Before and After Images
Upper ExtremityLengthening Before and After Images
Videos
Happy #paweek thanks for your great teamwork to care for our patients. Zac Edelman, Maxine Goyette, Bridget Ford, PA #physicianassistant #orthopedicphysicianassistant #Rozbruch #aaos #llrs #orthopedicsurgery #liveyourbestlife @all4ortho #orthopedicsurgeon #hospitalforspecialsurgery #limblengthening @hspecialsurgery @limbdeformity @reifmd #SRobertRozbruchMD www.limblengthening.com www.hss.edu/limblengthening www.hss.edu/LSARC #hssLLCRS #HSSlimbLengthening
Kevin always has a powerful T shirt. TKR on right and Osseointegration Limb Replacement Surgery on left has greatly improved his mobility. Left knee still okay but he will get TKR when ready proximal to the OI implant. #osseointegrationlimbreplacement https://www.hss.edu/osseointegration-limb-replacement.asp #osseointegration #amputationsurgery #amputee #cyborgsworld @cyborgsworld #amputeelife #amputeestrong #amputation #osseointegrationUSA www.osseointegrationUSA.com #prostheticlimb #prostheticleg #prostheticsandorthotics #limbreplacementsurgery #limbreplacement #osseointegrationaustralia #osseointegrationswholift #Rozbruch #aaos #llrs #orthopedicsurgery #liveyourbestlife @all4ortho #orthopedicsurgeon #hospitalforspecialsurgery #limblengthening @hspecialsurgery @limbdeformity @reifmd #SRobertRozbruchMD www.limblengthening.com www.hss.edu/limblengthening www.hss.edu/LSARC #hssLLCRS #HSSlimbLengthening
Using Xray and standing foot position and patient comfort to decide when the correction phase is complete. #tibialnonunion #limbtrauma #footandanklesurgery #Rozbruch #aaos #llrs #orthopedicsurgery #liveyourbestlife @all4ortho #orthopedicsurgeon #hospitalforspecialsurgery #limblengthening @hspecialsurgery @limbdeformity @reifmd #SRobertRozbruchMD www.limblengthening.com www.hss.edu/limblengthening www.hss.edu/LSARC #hssLLCRS #HSSlimbLengthening
Marilyn at age 80 was not happy with her large #knockknee and #kneearthritis I did #knockkneecorrection with #totalkneereplacement Prophylactic peroneal nerve decompression prevented stretch injury to the nerve with such a large acute correction. #Rozbruch #aaos #llrs #orthopedicsurgery #liveyourbestlife @all4ortho #orthopedicsurgeon #hospitalforspecialsurgery #limblengthening @hspecialsurgery @limbdeformity @reifmd #SRobertRozbruchMD www.limblengthening.com www.hss.edu/limblengthening www.hss.edu/LSARC #hssLLCRS #HSSlimbLengthening
Carol had a tibia #bonedefectreconstruction after #limbtrauma where I shortened the tibia using a precise compression nail and lengthened the femur using a #precicenail #limbsalvage #Rozbruch #aaos #llrs #orthopedicsurgery #liveyourbestlife @all4ortho #orthopedicsurgeon #hospitalforspecialsurgery #limblengthening @hspecialsurgery @limbdeformity @reifmd #SRobertRozbruchMD www.limblengthening.com www.hss.edu/limblengthening www.hss.edu/LSARC #hssLLCRS #HSSlimbLengthening
Last week I had the opportunity to speak at the 6th World Congress for ASAMI and ILLRS on topics of #limbtrauma , #limblengthening , #precice #precicenail , and #osseointegratıon . Glad to have spoken with my partner and mentor @limblengthening and our recent research fellow @jida_wanderer
Daysha before and after #knockkneesurgery #knockkneecorrection which improved body image , pain , and prospects for a bright knee future without #knockknees #knockknee #Rozbruch #aaos #llrs #orthopedicsurgery #liveyourbestlife @all4ortho #orthopedicsurgeon #hospitalforspecialsurgery #limblengthening @hspecialsurgery @limbdeformity @reifmd #SRobertRozbruchMD www.limblengthening.com www.hss.edu/limblengthening www.hss.edu/LSARC #hssLLCRS #HSSlimbLengthening
Victoria from Texas had a bad accident and came to me with a varus malunion and #leglengthdiscrepancy from #limbtrauma I corrected the varus with a closing wedge osteotomy and also performed lengthening with a #precicenail #Rozbruch #aaos #llrs #orthopedicsurgery #liveyourbestlife @all4ortho #orthopedicsurgeon #hospitalforspecialsurgery #limblengthening @hspecialsurgery @limbdeformity @reifmd #SRobertRozbruchMD www.limblengthening.com www.hss.edu/limblengthening www.hss.edu/LSARC #hssLLCRS #HSSlimbLengthening
