Mr S has been a patient of mine for many years.

He presented with a symptomatic short right leg as a result of a condition he was born with. He has a type of fibular hemimelia. This resulted in his right leg being much shorter than his left.

He approached me for a lengthening procedure. We established that this would be a long-term relationship and that we will both have to commit to the process.

We first embarked on a tibial lengthening, as he was too young for an intramedullary nail lengthening on his femur at the time.

We chose to use a circular external fixator for this purpose. External fixator time is long at approximately 1.5 months for every centimetre of bone lengthening. The up-side though is that the patient can bear weight during this time.

Because we use hexapod capable rings, we have the option of performing deformity correction during lengthening in the rare instance that a deformity develops during distraction.

The patient’s tibia was lengthened successfully, he grew older and became a teenager. Enough said. After a few years he came back for his second phase of treatment: femoral lengthening.

The xray above shows good healing of the tibia, but residual shortening of the femur.

We proceeded to plan and execute a femoral lengthening using one of the all internal methods, namely lengthening via an intramedullary lengthening nail. In this case we chose a retrograde Precice nail.

In these pictures we can see what the final result looks like. After many years of walking the road together, Mr S’s life was changed fundamentally. He can walk comfortably with legs that are equal in length – something we take for granted so easily.

#leglengtheningworks