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Limb lengthening is a reconstructive procedure that is performed on individuals whose bones are deformed or vary in length as a result of a disease, injury, or birth defect.


  • Congenital defects such as fibular hemimelia (absence of fibula bone)
  • Congenital short femur and hemiatrophy (absence of one side of body part)
  • Unequal limb lengths
  • Growth plate injuries
  • Bone infections resulting in limb length variations
  • Broken bones as a result of trauma
  • Replacement of missing bone after surgical removal of a bone tumor or fracture site
  • Increase the stature in dwarfs by lengthening both of the legs


Phase 1: Surgery

During surgery, a small incision is made to gain access to the part of the bone to be cut. An external fixation device is then put in place to hold the bone ends in proper position and alignment as new bones cells regenerate. At present, newer purely internal devices are also being utilized with great success.

Phase 2: Distraction Phase

Bone lengthening begins within a few days or weeks after surgery. Typically when a bone is pulled apart it regenerates at a rate of approximately 1mm per day. In the case of an external fixator, the patient or a caretaker makes prescribed adjustments to the device a few times per day to promote bone regeneration. X-rays are taken during regular follow-up visits to check for new bone growth, nerve and muscle function, and also to avoid any further complications.

Phase 3: Consolidation Phase

Adjustments to the device end once the desired length is achieved. However, the newly formed bone is still weak at this point and requires the continued support of the fixation device. X-rays are taken at regular intervals to monitor healing of the bone.

Phase 4: Removal of the External Fixator

The fixation device is removed when the bone becomes solid. In the case of an external fixator, a cast is applied to the limb for a few weeks to a month to provide protection as the bone continues to heal.


  • Delayed union or nonunion of bone
  • Premature consolidation of bone
  • Unbalanced forces can bend the bone during the lengthening process
  • Muscle contractures
  • Passive stretching and soft tissue mobilization
  • Muscle weakness
  • Nerve Injury
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Paley European Institute Medicover Hospital
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