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Casestudies  >  Limb Lengthening  >   Extensive Lengthening for Dwarfism   >   Complete lengthening of all segments

 

Extensive Lengthening for Dwarfism

 
 

    4½ year old child with enlightened parents decided to undergo lengthening. Since they were unsure, initial lengthening was performed with bilateral double level tibial lengthening. This gave her 11 cm of length which is almost 80% of the initial length of her tibiae. At the end of treatment, the nerve and joint functions were normal. Buoyed with this success, they decided to go ahead with more procedures to enable her to achieve significant gain!         best age to start lengthening treatment in Achondroplasia is 4 years or lesser. The children are small, implicitly believe in their parents and accept treatment, are easy to manage with the apparatus. They get significant amounts of height and hence before they go to play school they look like their peers and do not develop complexes. Most important, they tend to get improvement of their facial features when treatment starts early.                           -bowing deformities in tibia. this causes osteoarthritis early in life and lengthening combined with deformity correction prevents the arthritis.                      Bilateral Double level tibial lengthening with corticotomies in the upper and lower metaphyses. Excellent bone formation is seen .      

                          11 cm lengthening which is almost 90% of the initial length. There are no deformities and axial deviations after lengthening.                               -full dorsiflexion movement of the ankle joints and intact lateral Popliteal nerve function despite significant lengthening.

Lengthening of all segments in Achondroplasia for increase of height and restoration of bodily proportions

 

                     shortening of the upper extremities causes bending and kyphosis in the dorso-lumbar spine. Also the body proportion is distorted and hands reach only as far as hips rather than reaching to mid-thighs as in most normals.                                           bilateral humeral lengthening with Ilizarov fixators, applied in such a way as to permit full mobility of shoulder and elbow joints.           

                9 cm of length with very good regenerate formation.                            body proportions are restored with hands reaching mid-thigh after humeral lengthening

After a few years, it was noticed that her arms were very short and extended barely to her hips. The spine height is normal. When these children sit on a chair their height seems normal since it is only a short limbed dwarfism.
In order for hands to reach dowm they tend to constantly bend forwards and hence this results in a Dorso-Lumbar kyphosis.

         First phase of cross Lengthening with Right Femur and Left tibia                      achieved 14 cm of height in this treatment. No complications                              Full Knee movement and hip function after 10 cm lengthening of femur

Finally she had cross lengthening with both femur and both tibiae being lengthened in two stages.She achieved 14 cm of height in this procedure.
Totally she had lengthening of 33 cm and now she stands at 4'11" and is brimming with confidence and is a very talented and capable young lady.