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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 to upload your x-rays.

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Return to Sports

You have to regain your motion, muscle strength, and dexterity before returning to sports. If you work hard at this, you can go back as early as a month or two after the bone is solid. This is at approximately 6 months from surgery for most 8cm femur and 5cm tibia lengthenings. The bone healing is determined by Drs. Paley and Robbins from the radiographs you send in.

Drs. Paley & Robbins have performed implantable lengthening of the femur and tibia using a variety of devices (the Albizzia, ISKD). They have the largest experience in the world using the Precice and STRYDE nail. To date, all of their patients have achieved the goals of treatment and have returned to full activities including sports. Several articles of our published results are downloadable from this website.

Second Lengthening

If you choose to have a second lengthening done (e.g. bilateral tibias after completing bilateral femurs), an interval of one year or more is recommended between lengthenings. It is possible to overlap the femoral and tibial lengthenings (option 3).

Simultaneous Lengthening

The major benefit of simultaneous lengthening is to achieve a greater lengthening than possible with one bone segment during your stay in West Palm Beach. Several strategies exist to achieve goals of up to 16 centimeters. Review the Lengthening Strategies for more details.

Although femoral and tibial lengthening can be done simultaneously, we do not insert the femoral and tibial rods at the same time due to the theoretical risk of fat embolism from reaming the medullary canal of more than two bones at a time. To insert four rods in the same surgery would increase the chance of fat embolism and death.

With a simultaneous lengthening strategy the tibial lengthening is performed first. This is done for several reasons: tibial lengthening is performed more slowly than femurs, tibial healing takes longer than femurs, and tibial lengthening technique requires full knee flexion to perform. Femur lengthening is performed 3 weeks after tibial lengthening.

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