FEMORAL LENGTHENING

Standard femoral lengthening frame consist of a proximal fixation block made of two arcs, a distal fixation block made of two identical sized rings and an “empty” middle ring (usually one size larger) to link the two fixation blocks

FemurLengthning before surgery

FemurLengthning_before treatment

(a)before surgery

(b) before surgery

during treatment

during treatment - femur lengthning

(c) during treatment

(d) during treatment

Femur_Lengthning
(e) during treatment



AFTER TREATMENT


  • Physical therapy and crutch walking with partial weight immediately.
  • Distraction delayed for 5- 7 days @ .25mm four times per day
  • Patient and family are taught pin care before the discharge i.e. 5-7 days after surgery.
  • First X-ray after 7-10 days.
  • Regenerated bone seen in 4-6 weeks.
  • Weight bearing and functional activity aid in maturation
  • Ultra sonography can detect cyst formation, if large may require cancellous bone draft.
  • Knee flexion contractures and ankle equinus can be prevented by splints.
  • Fixator is removed when there is evidence of corticalization of the regenerated bone and is able to walk without aids.
  • For lengthening more than 6cm, double level lengthening can be used. In this modification 3 rings are used with a drop wire off each ring to give bi-level fixation of each segment.