Limb Lengthening Surgery Patient Guide

Limb lengthening surgery is a complex but rewarding procedure for individuals seeking to correct leg length discrepancies or increase their height. If you are considering limb lengthening in Turkey, it is essential to understand the preparation process, the surgery itself, and the recovery journey in detail.

BEFORE SURGERY

Consultation & Evaluation

A comprehensive consultation with an orthopedic surgeon is required. During this session:

• Your medical history and current medications will be reviewed.
• Physical examinations and imaging tests (such as X-rays, MRI, or CT scans) will be performed.
• The surgeon will determine whether the LON (Lengthening Over Nail) or Precice 2 method is most appropriate for your needs.

Pre-Operative Instructions

To ensure a safe and effective procedure:

• Stop the herbal supplements that increase bleeding (garlic, ginkgo, green tea, cinnamon, ginger and similar) 10 days before surgery.
• Aspirin and blood-thinning medication are a separate question, answered by the doctor who prescribed them together with your surgeon. Never stop a prescribed blood thinner on your own. For some patients stopping it is more dangerous than the bleeding risk it is meant to prevent.
• Stop smoking and drinking alcohol 2 weeks before surgery to improve healing and circulation.
• Inform your doctor of any drug allergies.
• Adjust your medications as directed by your physician.
• Do not eat or drink anything 12 hours before surgery.
• Maintain a balanced diet rich in protein, calcium, and vitamin D to promote bone healing.
• Keep your weight stable, as significant fluctuations can affect recovery.
• Prepare for physiotherapy by maintaining good joint flexibility and muscle strength before the procedure.

What to Bring to the Hospital

• Comfortable, loose-fitting clothes with front zippers or buttons
• Flat shoes to assist with mobility after surgery
• Personal hygiene items, such as baby wipes, especially useful during early recovery
• Entertainment, such as books, a laptop, or headphones, for your hospital stay

Anesthesia & Procedure

The surgery is performed under general anesthesia. Two techniques may be used:

• LON Method (Lengthening Over Nail): Combines external fixators with an internal nail for added stability. The external device is removed after the lengthening process.
• Precice 2 Method: Utilizes an internal magnetic nail for remote-controlled bone lengthening, eliminating the need for external fixators.

Hospital Stay

Patients typically remain in the hospital for about 5–7 days after surgery for close monitoring. During this period, pain medications and antibiotics are provided to manage discomfort and reduce the risk of infection. The nursing team and coordinators will support you with medical equipment, medication guidance, and mobility assistance to help you recover safely.

AFTER SURGERY

Recovery Stages

Immediate Post-Operative Phase (Week 1)

• You will remain in the hospital for monitoring of pain, infection, and wound care.
• Physiotherapy begins early to preserve joint mobility and flexibility.

Lengthening Phase (2–3 Months)

• Daily bone distraction (lengthening) is performed using the external fixator or Precice remote control.
• X-rays every 2–4 weeks will monitor bone formation and progress.
• Physiotherapy continues to maintain flexibility and muscle strength.

Consolidation Phase (9–12 Months)

• The newly formed bone gradually hardens and becomes strong enough to bear weight.
• Patients progressively return to normal daily activities.
• For LON patients, external fixators are removed with a minor procedure once bone healing is confirmed.

Lifestyle & Care Guidelines

Mobility

During the lengthening phase, you will need to use walking aids such as a walker or crutches. The Precice 2 system provides improved mobility and helps maintain a more discreet appearance throughout the process.

Work & Daily Life

Most patients can return to work and resume light daily activities after about 4 to 5 months. Light sports can typically be started around 6 to 9 months, while full recovery usually occurs between 9 and 12 months.

Nutrition

It is important to eat protein-rich foods and maintain a high intake of calcium and vitamin D to support bone growth. Staying well-hydrated is also essential during the entire recovery phase.

Hygiene

Keep the surgical areas clean and dry at all times. Baby wipes can be used for hygiene until regular showering is allowed.

Scarring & Skin Care

Once the wounds have healed, you should apply SPF 30+ sunscreen to the scars for at least one year to prevent discoloration and protect the skin.

Pain & Discomfort

Some level of discomfort is expected during the lengthening stage. Pain management support and prescribed medications will be provided to help ensure you remain comfortable.

Risks

As with any major surgery, potential risks include infection, delayed bone healing, and joint stiffness. Following medical advice carefully and adhering to all care instructions will help reduce these risks.

Key Reminders

• Minimum age requirement: 18–20 years (growth plates must be closed).
• Maximum recommended age: 50 years (exceptions may apply for healthy individuals).
• Average achievable lengthening:
• Tibia: 5–7 cm
• Femur: 8 cm (occasionally up to 9 cm with LON)
• For increases beyond 8 cm, a second surgery may be required.