What to Expect at the Limb Lengthening and Reconstruction Center

For more than 30 years, we have treated children of all ages who have limb deformities and deficiencies, including differences in arm or leg length. Children from around the world come to Cincinnati Children’s for our expert surgical and non-surgical approaches to bone and joint deformities.

Our team includes experts in orthopaedic surgery, physical therapy, occupational therapy, rehabilitation, and prosthetics and orthotics. They work together to provide personalized care for each child. Our goal is to help your child live as fully and actively as possible.

If your child needs surgical limb lengthening, read below to learn what to expect before and after surgery.

Making an Appointment at the Limb Lengthening & Reconstruction Center

Most insurance companies require a referral to our services from your child’s primary care physician or another physician they see. Please make sure you have this referral before you contact us for an appointment.

We also offer online second opinions for patients and families inside the United States who live beyond the Greater Cincinnati area.

Preparing for Your Visit

Before your child’s surgery, they will need some testing that may include:

• Blood tests

• X-rays

• Computed tomography (CT) scans

• Magnetic resonance imaging (MRI)

You’ll also visit with your child’s surgeon to learn about the procedure and what you can expect afterward. We encourage you to ask any questions you have during this appointment. We want you to feel as comfortable as possible about your child’s treatment plan.

On the Day of Your Child's Surgery at the Limb Lengthening & Reconstruction Center

Before Your Child’s Surgery

Please arrive at the hospital two hours before your child’s scheduled procedure. We perform surgeries on the Burnet campus. Because these are large facilities, please allow an extra 15 minutes to park and walk to the pre-surgery area.

Please contact us if you are running late for your surgery.

At Your Child’s Surgery

Before your child’s surgery, they will be placed under general anesthesia so that they sleep through the procedure.

Once they are asleep, your child’s surgeon will carefully cut the bone. The bone that has been cut can be gradually distracted (pulled apart) over time, which leads to new bone formation. Your child’s surgeon will then attach a fixator to support the bone as it is lengthened.

• An external fixator is a device worn outside the body that is connected to the bone with pins. The pins pass through the skin to connect the device to the bone.

• Intramedullary (internal) lengthening devices are inserted into the bone at the time of surgery.

Our nurse coordinator will keep you up to date throughout your child’s procedure. When their surgery is complete, you can visit them in the post-anesthesia care unit (PACU). Your child’s surgeon will talk to you about the procedure and how it went before you see your child.

Your child will stay in the hospital several days after the procedure. They will receive physical therapy in the hospital before you go home. We also will teach you how to care for your child and their fixator at home.

After Your Child's Surgery at the Limb Lengthening & Reconstruction Center

Physical therapy may start the day after your child’s operation. Therapeutic exercises are important to make sure that the bone is surrounded and supported by healthy muscles, and to ensure that joints function well. Your child’s surgeon, nurses and physical therapists will plan an individual program of care with you, and the therapy will be adjusted as your child progresses through treatment.

Within a few days of a leg lengthening and correction procedure, your child may be able to stand and begin to walk with the help of crutches. At first, they’ll be allowed only to put some weight on the operated leg. A physical therapist will teach your child how to use crutches and advise how to get around at home right after surgery. As the leg continues to heal, your child will become able to bear more weight on the leg.

After your child’s surgery, they’ll also need to visit our surgeons weekly. These visits are necessary to avoid complications that would slow down the treatment and healing process.

We will show you how to adjust the length of your child’s fixator. You’ll need to do this several times a day. This lengthens the bone by just 1 millimeter a day, which is a comfortable rate for the new bone cells to grow. Muscles, nerves and blood vessels grow along with the bone in response to this slow stretch, just as they do during a growth spurt.

By taking regular X-ray or ultrasound pictures of your child’s bones, their doctor will make sure that the lengthening isn’t happening too quickly or too slowly. Your child’s doctor may ask you to adjust the rate of lengthening as a result of progress shown on the X-rays.

Even when the limb reaches the right length, your child will still wear the fixator while the bone grows strong. Your child may need to wear a plaster cast for a short time after the fixator has been removed during a second surgery.

We’ll stay in close touch with you during the weeks that follow surgery. Feel free to call us with any questions you have between appointments.