Who is a candidate for bone lengthening?
Indications for Treatment of Limb Length Discrepancy (LLD) Most patients of normal height with LLD of less than 2 cm are minimally symptomatic. Surgical treatment is indicated for discrepancies above 2.5 centimeters (one inch). Bone shortenings, either growth plate arrest in the growing child, or femoral shortening in the adult, are considered appropriate for discrepancies from 2.5 to 6 centimeters. Tibial shortening is a dangerous operation because of compartmental anatomy, and difficulties in wound closure, and is also very disfiguring because of distortion of the leg profile. Bone lengthening is appropriate for discrepancies between 3 and 10-15 centimeters, however the upper limits have been changing as we refine the methods of distraction osteogenesis. Bone has excellent capacity for regeneration, but the soft tissues (ligaments, tendons, muscles) resist stretching, and joint surfaces don t tolerate massive lengthenings (> 15%). These soft tissue problems continue to limit safe len
