Limb Length Treatment for short limb in Gurgaon, Delhi
Seeking to resolve limb length discrepancy of your child? It is advisable to get limb length treatment as soon as possible for best recovery. Dr. Ratnav Ratan is a highly experienced pediatric orthopedic doctor practicing in NCR Delhi and Gurgaon with his practice spanning nearly thirteen years. Dr. Ratnav Ratan offers Limb Length treatment in Gurgaon, Delhi.
What is limb length discrepancy?
Limb length is a gradual process that helps to lengthen the bones of upper and lower extremities viz. the arms and the legs. This process focusses on increasing the length of the bones and soft tissues. Limb lengthening procedure may take quite a long time to deliver results. The procedure is also combined with acute deformity correction for better outcomes.
The limbs treated through limb lengthening processes are –
- Humerus – upper arm bone
- Radius/ulna – forearm
- Femur – thigh bone
- Tibia – shin bone
- Metatarsals – bones in the foot that affect toe length
Symptoms
The symptoms related to limb length discrepancy depend upon the cause and extent of difference.
Mild or slight limb length differences are likely to go unnoticed. Significant discrepancies such as 4 cms or 1-2/3 inches are visible through limping or an abnormal walking gait. Also, the patient finds it difficult to not only walk but run and play as well. The patient may complain of exertion as extra effort is required to stay mobile.
It is possible to get Limb Length treatment in Gurgaon, Delhi by consulting Dr. Ratnav Ratan.
Causes
Earlier injury to a bone in the leg
Limb length discrepancy can occur if a broken bone heals in a shortened position especially if it has broken in multiple pieces. Along with this, there has been substantial injury and exposure of the skin and muscle tissue around the bone. This condition resembles to that of an open fracture.
It is possible that the broken bone grows at a faster rate making it longer that the opposite bone. This type of overgrowth is noticed in children who have recovered from thighbone fractures. Also, it is possible that recovery of injuries near the growth plate result in slower growth and hence a shorter leg.
Bone Infection
Children who have been affected by bone infection in their growing stage can develop limb length discrepancy. This is noted in cases of bone infection during their infancy stage.
The incidence of certain bone diseases can lead to limb length discrepancy –
- Neurofibromatosis
- Multiple hereditary exostoses
- Ollier disease
Causes of limb length discrepancy due to neurologic conditions
- Juvenile arthritis – This condition leads to inflammation of joints in growing children
- Idiopathic or unknown reasons – At times, there is no specific reason or undiagnosed condition pointing towards partial overgrowth of one side of the body or the underdevelopment of either the inner or the outer side of the leg. The children could be born with these conditions but their length discrepancy can go unnoticed till the children grow further.
In case of underdevelopment, any one of the two bones located between the knee and the ankle is very short and the child may have problems of the foot or the knee.
Equally rare are the incidences of Hemihypertrophy and hemiatrophy in case of children of limb length discrepancy. Hemihypertrophy refers to extremely big one side while hemiatrophy relates to very small one side. The face of the child may also bear a visible discrepancy.
Dr. Ratnav Ratan offers consultation to patients who wish to know more about the causes of limb length discrepancy and limb Length treatment in Gurgaon, Delhi
Diagnosis and Doctor Examination
Parents should observe their child for limb length discrepancy especially. In case of a doubt, consulting a pediatric orthopedist is the best way out who will conduct a thorough physical examination and specials tests
A visit to the pediatric orthopedist means sharing medical as well as general history and symptoms related to limb length discrepancy. The doctor could suggest the child to sit, move, and stand too.
Physical Examination
During the exam, your doctor will ask about your child’s general health, medical history, and symptoms. He or she will then perform a careful examination, observing how your child sits, stands, and moves. Also, the child will undergo gait analysis; in case of limb length discrepancy, the child will flex his or her knee or walk on their toes. The doctor could use wooden blocks to provide additional length to the short legs and get the hips at par.
X-rays, CT- Scans and scanograms which are special x-rays that use a series of three images and a scale for measuring limb length can also be recommended. CT scans are useful in measuring the length discrepancy of the limbs.
Treatment of limb length
The limb length treatment majorly depends upon the following points
- The extent of discrepancy
- The age of the child
- The reason for discrepancy
For limb length discrepancies of less than 1 inch, non-surgical treatment is advised. The reason being risks associated with surgery outweigh the benefits of the surgery.
The most recommended non-surgical treatment includes wearing a shoe lift. This lift is fitted either within the shoe or outside the shoe and works to improve the mobility of the patient. It can also relieve the patient of incessant back pain, if experienced.
Surgical Treatment
The pediatric orthopedist will recommend surgeries to resolve limb length discrepancy by
- Slowing down or stopping the growth of the longer limb
- Reduce the length of the longer limb
- Extend the length of the shorter limb
Epiphysiodesis
Epiphysiodesis is a suitable mode of treatment for growing children. It focuses on slowing or stopping the growth at either one or more growth plates in the longer limb.
Limb Shortening
Limb shortening is possible on patients who have attained their complete growth. As the name of the treatment suggests, the longer limb is shortened through a surgical procedure. The outcome of the treatment is to reach equal length by the time, the child reaches his or hers teenage years. Hence, the timing of performing the limb shortening procedure plays a crucial role in the treatment.
Limb Lengthening
This treatment is suggested with patients with considerable discrepancies in their limb length. This procedure is performed either internally or externally. Also, the outcome of such procedures expected is approximately 1 inch per month or 1 mm per day. Internal and external lengthening require extensive rehabilitation especially home exercise and physical therapy along with timely visits to the doctor for follow ups.
Dr. Ratnav Ratan offers comprehensive limb Length treatment in Delhi NCR and Gurgaon.
FAQs
In general, the bone lengthens approximately 1 mm daily, however this differs from patient to patient.
In a single lengthening treatment, up to 5 cms or 2 inches of a bone can be lengthen especially in the thigh bone and the shin bone which means lengthening up to 4 inches is possible.
The bones of some patients heal faster while the regenerated bone may harden before the completion of the treatment. Also, once the regeneration sets in, the treatment is considered complete while outcome of the lengthening could not be attained. In such conditions, surgical procedures are performed to ensure that the limbs are lengthened as per the requirement of the patient.
The limb lengthening process is slow if the patients smoke or suffer from diabetes.
Which surgical procedures are performed in case of issues during the healing period after the limb lengthening surgery?
Bone graft is a procedure that involves inserting bone tissue within gap located between two bone segments to help regeneration of the bones. Nerve decompression procedure to reduce the pressure on a pinched. In case of tightening of soft-tissues i.e. muscles, tendons, nerves and ligaments suitable physical therapy is recommended to relieve them of the tightness
Yes, this varies from person to person and case to case.
Most pediatric orthopedists recommend at least 2 – 3 limb lengthening procedures in children till they reach 16 years. It is possible that other procedures such as epiphysiodesis or deformity correction are combined with the limb lengthening procedure.
Dr. Ratnav Ratan, one of the leading orthopedic doctors in North India offers complete limb Length treatment in Delhi and Gurgaon.
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Post-surgery rehabilitation comprises of physical therapy sessions and home exercises aimed at improving muscle strength and range of motion. If they are not done regularly, it could lead to muscle contractures, stiff joints or dislocated joints. The aftermath of this implies stopping the lengthening process either permanently or temporarily.
Which factors ensure success in patients who have undergone limb lengthening procedures?
Most limb lengthening patients have had better walking style, and range of motion along with considerable improvement in muscle strength. Choosing an expert and experienced pediatric orthopedist for the limb lengthening treatment is very crucial for comprehensive resolution of the discrepancy.It is equally important to have an expert physical therapist with total focus on the rehabilitation program for best outcomes.
