Limb lengthening surgery in Turkey is performed for medical reasons in most cases. However, in recent times, it has become common to undergo the procedure for cosmetic purposes as well, as it can be done at lower costs and with the latest techniques.
Overview of the limb lengthening procedure
The process of bone lengthening primarily relies on the bone’s own self-healing ability. In the case of a bone fracture, the bone repairs itself over time. The same applies to blood vessels and soft tissue. Doctors have utilized this characteristic to develop the bone lengthening procedure.
In 1950, Russian physician Gavriil Ilizarov invented an external fixator device (known as the Ilizarov device), which revolutionized the field of leg lengthening surgery and is still used today.
New techniques have been developed in the field of height increase surgery, such as internal fixation devices, which we will discuss in our article.
Stages of limb lengthening and height increase
The stages of limb lengthening surgeries vary depending on the devices used, but there are basic stages present in all techniques, which are:
- Bone fracture stage: The doctor surgically breaks the bone.
- Lengthening (distraction) stage: In this stage, the device used (internal or external) is used to fix the device to the bone. Then, the broken ends of the bone are gradually pulled apart, lengthening the broken ends of the bone by approximately 1 millimeter per day. This process allows for the formation of new bone in that area.
- Consolidation (hardening) stage: In this stage, the new bone undergoes consolidation and increases in hardness.
Who is eligible for limb lengthening surgery?
At that time, the Russian doctor Ilizarov invented the external fixation device to correct congenital defects and limb deformities such as leg length discrepancy (one leg shorter than the other). The purpose of the procedure is to correct the discrepancy to prevent problems with the spine, knee, and hip that result from walking on uneven legs.
The procedure is also performed for patients with short stature who have dwarfism. Currently, the procedure is also used for cosmetic purposes in healthy individuals aiming to increase their height.
Types of limb lengthening and height increase procedures
There are several techniques used to perform height adding surgery, including those that involve the use of external devices that surround the person’s skin, and those that rely on the use of internal screws placed inside the bone. Some of the important methods used in limb lengthening in Turkey are as follows:
Ilizarov technique
The Ilizarov technique involves a circular external fixation device that is secured around the bone using metal wires. This technique can be used for limb lengthening operations and the treatment of fractures and deformities.
The device is applied to the thigh or leg bone, and the patient can start walking with crutches from the day after the surgery. It is relatively low-cost.
One of the drawbacks is the risk of infection at the site where the device is placed, and this technique may be uncomfortable for the patient due to the large size of the device. It may also leave marks on the skin where the wires are connected for lengthening.
Holyfix technique
This is a unilateral external device that is attached to the bones using fixation screws. This device is lighter in weight as it is made of titanium, making it lighter than the Ilizarov device.
It differs from Ilizarov in that the risk of infection is lower, and it is more comfortable for the patient with less likelihood of leaving marks on the skin compared to Ilizarov.
One of the drawbacks is the long time the device needs to be worn, as it is only removed after the consolidation and mineralization stage of the bone is completed.
LON technique
This technique is a combination of an external device similar to the Holyfix device responsible for lengthening and an internal nail responsible for fixation that is surgically placed inside the bone.
Among the commonly used reliable techniques, it is characterized by the ability to remove the external device early after the lengthening phase, unlike the Holyfix and Ilizarov techniques, where the device is removed after the consolidation phase. However, it is relatively expensive.
Precice 2 technique
This technique relies solely on an internal nail without the need for an external device. The nail is made of titanium and is surgically implanted inside the bone, and is controlled using an electromagnetic device.
One of the advantages of this technique is the absence of an external device that may bother the patient, and the nail can remain inside the bone, eliminating the need for nail removal after the lengthening and consolidation phase. The nail is engineered to be compatible with the bone and does not interfere with magnetic resonance imaging (MRI).
The drawback of this method is that the patient needs a wheelchair during the lengthening phase due to the nail’s inability to bear the body’s weight.
STRYDE technique
This is an advanced technique in the field of orthopedic and surgical height increase and is an improved version of the Precice 2 technique. It also relies solely on an internal nail without the need for an external device.
The nail in this technique is made of reinforced steel, allowing the patient to bear weight without the need for a wheelchair. However, it is extremely expensive.
Preparation before bone lengthening surgery
Before nominating the patient for leg elongation surgery, the limb lengthening surgeons should conduct a comprehensive evaluation of the patient’s condition. It is possible that the discrepancy in limb length is due to a completely different medical problem that the patient is unaware of, such as scoliosis or a deformity in the hip bone. It is also possible that the patient has a misconception about the difference in limb length.
In fact, the patient should also be fully aware of the nature of the surgical procedure and be motivated for it. The recovery period from the surgery is somewhat long, and the patient requires continuous physical therapy for several months. It is possible that the patient may need to use crutches for a period of time. Therefore, it is important to ensure that the patient is motivated and prepared for this procedure.
In some cases, in children who have a certain bone deficiency or deformity compared to the adjacent bone, the operation can be repeated after a period of time. During the child’s growth, the discrepancy in limb length can increase from 2 cm to 3 cm due to a problem with the growth plates (responsible for bone growth) in one of the limbs.
Recovery after height lengthening surgery
In reality, the recovery period varies from patient to patient, as the consolidation period may take a long time for the new bone to take its shape and strength.
As a general rule, children require half the recovery time needed for adults, as children have a better ability to regenerate bones compared to adults.
The duration of recovery also depends on the desired length to be added to the bone. The longer the desired length, the longer the recovery time needed.
Physical therapy plays a crucial role in accelerating recovery, as it helps muscles stretch and maintains joint flexibility.
Patients who have undergone this procedure are advised to take calcium supplements as they need to expedite the healing, hardening, and building of new bone.
Patients are prohibited from smoking during the recovery period because smoking slows down the process of consolidation and the acquisition of sufficient strength in the newly formed bones.
Results of limb lengthening procedure
Usually, the lengthening of a single bone, specifically the femur, is about 5 to 8 centimeters. Lengthening the bone beyond that may be associated with a higher rate of complications. However, if the patient desires to gain more centimeters, another surgery can be performed after approximately one year to lengthen the leg bones (tibia and fibula) and add an additional 5 to 8 centimeters. This way, the patient can gain a total of 15 centimeters added to their height.
In some cases, the doctor may perform a simultaneous surgery to lengthen both the femur and the leg bones. However, this surgery is more challenging for the patient, and recovery is more difficult, with a higher likelihood of complications.
My experience with limb lengthening surgery
“Don Davis” recounts his experience with limb lengthening surgery and how it had a significant impact on his life, saying:
“I still remember the first race I participated in, in New York, and how much I enjoyed running, swimming, and cycling. In 2011, I had a severe bike accident while participating in a triathlon championship, which resulted in a fracture in my femur bone. The doctor at the hospital treated the bone fracture, but it didn’t heal properly over time, to the point where I lost an inch in my femur length.
Sports were a big part of my life, so I turned to a doctor who advised me to undergo limb lengthening surgery. Thankfully, the surgery went very well, and the discrepancy in length between the limbs was corrected. I can still run and engage in sports activities up to this moment.”
Risks of limb lengthening and height increase surgery
Limb lengthening surgery may be accompanied by some complications, including:
- Infection at the site of the external device
- Delayed bone healing
- Scarring at the device fixation site
- Nerve or blood vessel injury
- Failure of new bone formation at the fracture site
By proper planning and collaboration between the doctor and the patient, complications can be avoided as much as possible. Let’s not forget the role of the patient in the recovery phase, which includes physical therapy.
Limb lengthening surgery cost in Turkey
In fact, the cost of the operation varies depending on the technique and device used. The Ilizarov technique is the oldest and least expensive, while the modern STRYDE technique costs the most.
The cost of limb lengthening surgery using the Ilizarov technique in Turkey starts from $17,000 USD, while the cost of the Precice nail (PRECICE technique) for bone lengthening in Turkey starts from $35,000 USD. It’s worth noting that the price of limb lengthening surgery with an internal fixator varies depending on the type of material used.
Rest assured that Turkey is your first and best choice for bone lengthening surgery, not only due to the relatively lower cost but also because of the presence of advanced surgical centers and a distinguished medical staff who have successfully performed these types of surgeries at a high success rate
