Stature Lengthening Consultation and Surgery
Initial Consultation
The consultation starts with a specialized standing x-ray called an EOS scan. This is a low-radiation dose scan of your entire body from head to foot in a biplanar fashion (front and side at the same time). This scan may be performed the day before your consultation.
You will meet with our Stature Lengthening Coordinator, Angelique, and one of our Physician Assistants (PAs), Vera, John, or Allan. They will obtain your medical history and explain the lengthening process in detail…
Surgery
The stature lengthening surgery consists of an osteotomy (surgical cut to the bone) that will separate the bone into two segments and insertion of the lengthening nail (the STRYDE).
There are many things that the surgeon must consider for stature lengthening surgery. It is important to determine the ideal nail length, insertion point (e.g. trochanteric vs. piriformis in the femur) and osteotomy level. The nail length and osteotomy level are very interrelated. To avoid too much friction, the osteotomy level is planned to leave one to three centimeters of the wider tube of the nail engaged in the opposite segment of bone (this is explained in detail below). When there is a larger femoral bow, we prefer to make the osteotomy at the level of the apex of the bow. Working backwards, this can help calculate the ideal…
Hospitalization
After surgery you will be taken to the recovery room for an hour or two before going to your room. If you have family or friends present, the surgery team will come out to talk to them after the operation. You will have an IV in your arm and a Foley catheter (bladder catheter). The Foley catheter will remain in place for a day or two While in the hospital you will start on mechanical foot compression pumps and an oral blood thinner to prevent blood clots. The nurses will make sure you are comfortable and positioned in such ways as to prevent pressure sores. You will have blood tests drawn each morning to check your blood level. In the rare event your blood level is low and you are having symptoms such a low blood pressure and an increased heart rate, a blood transfusion may be ordered. Each morning, the surgical…
Lengthening Phase
No lengthening is performed in the first week after surgery. This is called the Latency period.
One week after surgery, you will begin the lengthening (distraction) phase. During the lengthening phase, the STRYDE nail will lengthen the bone one millimeter per day femurs) or three-quarter millimeters per day (tibias). In patients older than 50 years old we may choose to lengthen at a rate of 0.75 mm per day even for the femur. Lengthening is performed by the ERC device and you will be instructed in its use by an Orthopedic Technologist after discharge. The turns are divided into…
Physical Therapy
Physical therapy (PT) is required daily (5 days per week) during the lengthening phase. The Paley Institute has a specialized physical therapy department on-site. All of the therapists have been specifically trained in the rehabilitation of lengthening patients and treat lengthening patients each and every day. This experience is crucial to ensuring a positive outcome, maximizing strength and flexibility, and preventing complications. The Paley Institute is unique among other centers in offering an on-site therapy department specifically catered to the lengthening patient. All physical therapy during lengthening is included in the cost estimate for…
Bone Healing Phase
Once the desired length has been achieved, you will enter the bone healing (consolidation) phase and you can return home. There will be no changes to your activity level or restrictions until your bone has healed adequately. This usually takes 3 months.
Continuation of physical therapy is important for strengthening, improving range of motion, and improving gait.
Once you return home you will need to send monthly x-rays to the institute for evaluation. The best way to do this is update this section. We have a way for patients to upload their x-rays for review…
Hardware Removal
Once the new regenerate bone has completely healed and you have returned to your normal level of activity the final step will be removal of the STRYDE nails. Removal of the nails is a minor outpatient procedure. You should plan to stay local over night and you return home…