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Orthopedics

Limb Lengthening Program

Once a patient overcomes a chronic infection or severe injury, he or she can actually be left with legs of different lengths. Known as leg-length discrepancy, this condition requires an orthopedic surgeon with a unique depth of experience.

At the Florida Hospital Orthopaedic Institute Orlando (FHOIO), our surgeons and medical staff possess the knowledge and skills to repair and treat leg-length discrepancy. They’ve had great success in performing these procedures cosmetically, such as for patients with shorter legs or two normal limbs of different sizes. Certain medical conditions, such as premature puberty, constitutional low stature or achondroplasia (dwarfism), may not involve a significant leg-length discrepancy. In these cases, cosmetic limb-lengthening surgery may be considered stature enhancement to increase height and for other functional indications.

Our physicians employ a process called distraction osteogenesis. To begin this treatment, the surgeon will split the bone in two and insert the limb-lengthening device. In essence, this surgical procedure pulls the uneven bones apart at a very slow rate. This enables new bone to gradually grow and heal until an equal length is achieved. The procedure also increases the surrounding soft tissue’s volume.

Previously, limb-lengthening procedures required awkward external devices that included pins and frames. However, in the early 1990s, J. Dean Cole, MD, a pioneer in orthopedic trauma surgery—and the FHOIO’s medical director—made some groundbreaking changes. J. Dean Cole, MD traveled to Russia to meet with Gavril Ilizarov, MD, an orthopedic surgeon and the developer of this procedure’s conventional external fixators and practices. Ilizarov taught J. Dean Cole, MD the procedure’s principles.  

After returning to America, J. Dean Cole, MD began performing the limb-lengthening surgery, but he knew a more effective treatment option was possible. Over the next 20 years, he perfected the process, seeking to design an internal device to obtain a predictable bone length.

In 2001, J. Dean Cole, MD achieved his goal, inventing the only FDA-approved, completely internal device to lengthen limbs, the Intramedullary Skeletal Kinetic Distractor (ISKD). This device relies on an internal lengthening process to increase height naturally. In the ISKD technique, surgeons implant a telescoping rod into the patient’s bone. This rod is gradually extended through a long-term, regular program of physical movements, specifically knee and/or ankle rotations.

As a result, these shortened bones are gradually extended until there are equal limb lengths. In addition, the patient experiences increased stability and alignment. As the bone grows, a level of control is provided by a handheld magnetic sensor, which monitors the bone growth on a daily basis.

These movements are very safe for patients. Before any limb-lengthening surgery is planned, J. Dean Cole, MD and his fracture care team figure out personalized, fully extended lengthening goals for each patient. The lengthening device is then preset to that planned length.

Unlike procedures requiring external fixation pins or wires, the ISKD is completely internal. As such, the risk of infections and scarring is dramatically reduced. To date, J. Dean Cole, MD and his surgical colleagues have performed this procedure on more than 100 patients. In addition, J. Dean Cole, MD’s ISKD is now employed by trained orthopedic surgeons throughout the United States and Europe.

You’ll find a more in-depth discussion of this procedure’s benefits and expected outcomes on the treatment page, as well as a real-life limb-lengthening case study. If you think you may be a candidate for limb lengthening, contact us today, or visit the Florida Hospital Orthopaedic Institute Orlando website for more information.