Robert Rozbruch, MD
212-606-1415

Austin Fragomen, MD
212-606-1550

Taylor Reif, MD
212-606-1637

Jason Hoellwarth, MD
212-606-1097

New patients: email us or call 646-681-7465

Limb Lengthening Overview

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

We are on Instagram
At the International Limb Lengthening and Reconstruction Society Meeting, I was honored to receive the Outstanding Achievement Award along side other leaders across the globe. #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
At the International Limb Lengthening and Reconstruction Society Congress in Beijing China. I delivered 8 invited lectures and met with many friends and colleagues from around the world. Exciting meeting attended by 1000 surgeons #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
Tim from Michigan several weeks post single stage Osseointegration Limb Replacement Surgery #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
Paul after #ankledistraction #ankledistractionarthroplasty with huge improvement in mobility and x-ray appearance. Look at that joint space and where did the subchondral cysts go?!!
#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
Neil with his wife from Colorado got his new leg today 8 weeks post single stage Osseointegration Limb Replacement Surgery #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
Rashi from Boston after #bowlegcorrection #bowlegs and #leglengthdiscrepancy related to #hypophosphatemicrickets #hypophosphatemia #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 #bowlegcorrection
Training for #bikehss #bikehss2024 Thanks to all of you that supported my ride this year and over the last several years!! #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
Juan and his wife from California only 6 weeks after he got his new leg post single stage Osseointegration Limb Replacement Surgery. He has a custom made porous coated titanium implant.  Check out the fit on the lateral Xray!! #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