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Limb Lengthening Surgery Risks, Complications, and Side Effects

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Are you considering limb lengthening surgery to increase height? The average male height is approximately 5 feet 9 inches (175 cm), while the average female height is around 5 feet 4 inches (162 cm). Limb lengthening surgery is one of the few ways to increase height. However, it's important to weigh the potential risks and complications before making your decision. In this comprehensive guide, we'll provide you with a detailed overview of the risks, complications, and side effects associated with limb lengthening surgery.

Understanding the Surgery Process

Limb lengthening surgery begins with an osteotomy, in which the bone to be lengthened is cut by the orthopedic surgeon. Following this, an external fixator or internal nail is used to fix the bone in place. Over time, the bone is gradually lengthened, allowing new bone tissue to form and fill the gap. However, this process is lengthy and requires close monitoring and follow-up care.

While limb lengthening surgery can be successful, it does come with potential risks and complications. Some risks include slow or rapid bone healing, muscle contractures, and osteomyelitis. Additionally, nerve damage, blood clots, and severe pain are possible complications of the procedure. It's essential to discuss these risks with your doctor and ensure that you are a suitable candidate for the surgery.

In addition to the risks and complications, limb lengthening surgery can also have potential side effects. These can include scars, visible deformities, and limited mobility during the recovery process. It's crucial to understand the potential side effects and to consider them before making a decision.

Making an Informed Decision

By gaining a thorough understanding of the procedure and the potential risks, complications, and side effects, you can make an informed decision about whether limb lengthening surgery is right for you. It's important to consult with your doctor and consider all of your options before making a decision.

Potential Risks and Side Effects

Slow or Rapid Bone Healing

One of the potential risks associated with limb lengthening surgery is slow or rapid bone healing. During the process of forming and healing new bone, some patients may experience either faster or slower bone healing than expected.

If rapid bone healing is observed during the lengthening phase, the doctor may adjust the daily lengthening amount to stabilize the process. However, if the bone has already united due to rapid bone healing, additional surgery may be required to correct the issue.

On the other hand, slow bone healing may occur in some patients. This can be detected through regular X-rays during the lengthening phase and may require a reduction in the daily lengthening amount, resulting in a longer treatment time than expected.

In rare cases, the bone may not unite at all, a condition known as nonunion. In such cases, the doctor may decide to stop the lengthening procedure, reverse it, or perform additional surgery to address the issue.

Muscle and Joint Complications

Limb lengthening procedures require muscle adaptation to keep pace with bone extension. If the bone and muscle lengths do not match up properly, it can lead to postoperative complications such as muscle contractures and joint stiffness.

Muscle contractures occur when the muscles do not adapt to the bone extension, causing pain and difficulty in movement. To prevent muscle contractures, patients should follow a regular exercise program and receive physiotherapy sessions. Early physical therapy intervention can help prevent muscle and joint contractures.

Joint stiffness and contractures occur when muscles become too tight, pulling on the surrounding joints and causing difficulty in joint mobility. To prevent and treat joint stiffness and contractures, patients should follow a regular exercise program and receive physiotherapy sessions. In rare cases, surgical intervention may be necessary to correct joint stiffness or contractures.

Bone Infections

Osteomyelitis, or bone infection, is a possible complication that can occur after limb lengthening surgery, especially with methods involving external fixation. To prevent osteomyelitis, patients should maintain proper hygiene, follow post-operative care instructions, and avoid exposing the surgical site to dirt or bacteria.

Regular needle site dressings and bandage changes can also help minimize the risk of infection. If osteomyelitis is detected, it can be treated with antibiotics and pain relievers in the early stages. However, in some cases, surgical intervention may be necessary to address the infection.

It's essential to closely monitor the surgical site for signs of infection, such as redness, swelling, and fever, and promptly report any symptoms to your healthcare provider. With proper care and attention, the risk of osteomyelitis and other complications can be minimized.

Nerve and Blood Vessel Damage

During limb lengthening procedures that involve external fixation, there is a slight risk of nerve and blood vessel injury. This can occur due to the insertion of pins and wires into the bone, which may compress or damage surrounding nerves and blood vessels.

Nerve injuries can result in temporary or permanent loss of sensation or movement. Treatment for nerve injuries may include physical therapy, nerve stimulation, and in some cases, surgical intervention.

Blood vessel injuries can cause blood loss and may require surgical repair in severe cases. Although these injuries are rare, it's important to be aware of the potential risks and to seek medical attention immediately if any symptoms occur.

It's crucial to closely monitor the surgical site for any signs of nerve or blood vessel injury, such as numbness, tingling, weakness, or excessive bleeding.

Infections at the Pin Site

Pin site infections can occur during limb lengthening procedures that use external fixation, such as the LON method. These infections can be caused by bacteria at the surgical site, poor dressing changes, or other issues. They can cause pain, slow healing, and other complications.

To prevent pin site infections, it's crucial to keep the surgical site clean, follow all post-operative care instructions, and closely monitor the surgical site. Treatment for pin site infections may include antibiotics, wound care, and surgery in severe cases.

It's important to note that the Precice 2 method does not carry the risk of pin site infections since it is fully internal and does not involve the use of external fixation.

Pin Loosening

In limb lengthening methods that use external fixation, such as the LON method, pin loosening is a potential complication that can occur due to various technical factors. These factors may include improper insertion technique, frame stiffness, and poor anchorage.

Pin loosening can compromise the stability of the fixation and may require additional surgical intervention to correct. However, it's important to note that pin loosening is not a common complication and can be minimized by following proper post-operative care instructions and closely monitoring the fixation during the healing process.


Postoperative swelling is a common complication after limb lengthening surgery, caused by the accumulation of fluid in the affected area. It can cause discomfort, pain, and difficulty in movement, and may impede the healing process, delaying recovery time.

To manage postoperative swelling, patients are typically prescribed medication, such as non-steroidal anti-inflammatory drugs (NSAIDs) and compression garments, and undergo physical therapy to help reduce inflammation and improve circulation. Physical therapy exercises can also help to improve the range of motion and prevent stiffness in the affected limb.

In some cases, the surgeon may use a technique called intermittent pneumatic compression to help reduce swelling and promote healing. Additionally, elevation of the affected limb and keeping the limb active can also aid in reducing swelling.

Pain and Trouble Sleeping

Pain is a common experience for patients undergoing limb lengthening procedures and can range from mild discomfort to severe pain. Pain is typically highest in the days immediately following surgery and gradually decreases over time with proper management and pain control.

However, pain tolerance and sensitivity can vary greatly among patients, and some may experience difficulty sleeping due to pain. The healthcare team and surgeon will work closely with patients to manage pain and ensure that treatment protocols are tailored to each individual's needs. This may include a combination of medication, physiotherapy, and other pain management techniques.

It's essential for patients to report any pain or sleeping difficulties they are experiencing to their healthcare team so that appropriate action can be taken to alleviate symptoms.

Mental Health Issues

Undergoing limb lengthening surgery can be an intense emotional and physical journey. It's crucial to have realistic expectations and be prepared for the process, including the treatment period and recovery time.

While the procedure can have life-changing benefits, it's important to keep in mind that there may also be potential emotional challenges to consider. Patients may experience anxiety, depression, or frustration during the treatment and recovery process. It's important to talk with family members, friends, and mental health professionals to help cope with the emotional aspects of the surgery.

Patients should also work closely with their healthcare team and surgeon to ensure that they are well-informed about the procedure, potential complications, and recovery process. By taking an active role in their care and seeking support from loved ones and mental health professionals, patients can successfully manage the emotional impact of limb lengthening surgery.

How to Minimize the Risk of Complications

To avoid possible risks, side effects, and complications associated with limb lengthening and deformity correction procedures, it is crucial to take the following precautions:

  1. Choose a qualified and experienced surgeon who specializes in limb lengthening and deformity correction procedures. Do thorough research, read patient reviews, and consult with other healthcare professionals before making a final decision. It's important to discuss advanced methods, different options, and the risks and complications associated with each method.
  2. Learn about the lengthening and treatment process. Before and after surgery, the surgeon and healthcare team should provide you with detailed information about the procedure and its potential risks. Make sure to understand and follow the doctor's instructions carefully.
  3. Follow the doctor's instructions during treatment. It's crucial to follow the doctor's instructions during the treatment process, including taking x-rays at regular intervals and sharing any changes in your health condition with the healthcare team and surgeon.
  4. Be aware of possible complications. Your surgeon will inform you about the most common risks and side effects, but there may be other potential complications as well. Get all the information you need and make sure you get the care you need.
  5. Communicate with your healthcare team. Keep an open line of communication with your surgeon and healthcare team throughout the treatment process. This will help ensure that any issues or concerns are addressed quickly and effectively.

Final Thoughts

In conclusion, limb lengthening surgery is a complex and intricate procedure that carries with it certain risks, complications, and side effects. While it is true that average height has been increasing over time, some people may still desire to be taller, and limb lengthening surgery is one of the few options available. However, it is important to understand that this procedure is not without risks. Patients should carefully consider the potential complications and side effects, as well as the benefits, before deciding to undergo the surgery. By taking the necessary precautions, choosing a qualified surgeon, and following the doctor's instructions, patients can minimize the risks and increase the chances of a successful outcome.

At the end of the day, the decision to undergo limb lengthening surgery should be made only after careful consideration and consultation with an experienced healthcare professional.

Caroline Buckee

Caroline Flannigan is an epidemiologist. She is an Associate Professor of Epidemiology and is the Associate Director of the Center for Communicable Disease Dynamics.

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