Limb lengthening: Orthopaedic surgical focus

Limb lengthening or height increase with Ilizarov technique has been used successfully in both femur and tibia. Bilateral lower extremity lengthening has been used to increase stature.

With the ability to safely and effectively perform this procedure, an increased interest has been observed in a group of people who are unhappy with their stature and thereby wish for an increment in their stature. Patients with a psychological state of 'short person dysphoria' seem to feel an intense need to increase their height.

With the appropriate psychological screening patients can be identified for stature lengthening. Our long experience treating such a group of patients has been very positive. Safe and successful stature lengthening of 2" to 3" can be accomplished. The excellent result is an outcome of increased happiness and an improved self-esteem.

Lengthening stature in normally proportioned individuals with short stature but without dysphoria (dwarfism) requires a different strategy for lengthening than in patients with disproportion and dysplasia. Most patients with constitutional short stature (CSS) or low normal stature (LNS) require only modest increase in stature compared to the extreme amount of lengthening required by patients with dwarfism. The lower limit of so-called short stature for Caucasian men is 5' 5" and Caucasian women is 5' 0". Patients with CSS and LNS also do not usually have pre-existing bone deformities.

We have found that patients who are the best candidates for stature lengthening are those who already have normal lives; they appear happy and motivated in other aspect of their lives but are having significant and frequent episodes of discontent due to short stature. Most importantly, they have realistic expectations from the outcome of surgical lengthening.

This is not a simple cosmetic operation. It is a procedure done in individuals who feel the need to undergo the surgery, but are otherwise mentally healthy.

We strictly follow the world's best surgical lengthening technique – from Russia's Ilizarov Scientific Centre in Kurgan. Gradual controlled coordinated distraction as well as consolidation is mandatory. This Ilizarov technique is well established and has been used for the longest time. The usual goal for lengthening of stature for most patients with Ilizarov fixator is 2-3".

This procedure one must still weigh the risks of undergoing a major surgical procedure versus the benefits of increasing one's stature by 2"-3". Proceeding with the surgery is a very personal decision.

The writer is a Visiting Professor at Ilizarov Centre, Kurgan, Russia.

Email: bari.ilizarov31@gmail.com