Limb Lengthening Surgery Overview

What Is a Bone Length Discrepancy?

Our service is dedicated to correcting limb length discrepancies through limb lengthening surgery, which causes 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.  

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 limb lengthening surgery called 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.