Limb lengthening is based on the discovery of Gavriil Abramovich Ilizarov (“Ilizarov Effect”) - the bone responds to dosed stretching (distraction) with growth and regeneration.
The Ilizarov method is one of the few domestic developments that has received worldwide recognition and is widely used to treat fractures, eliminate bone defects and deformities, and also to lengthen limbs.
Indications:
- congenital disproportion of the thigh and lower leg;
- shortening of the lower limb due to injury or illness;
- objectively short stature, subjectively short stature or bowed legs.
Simply put, the main indications for using the Ilizarov method are purely medical and aesthetic. In the case of aesthetic reasons, it is almost always the legs. Both reasons require preoperative planning and the patient's willingness to wear the device for a long time. In the first case, the surgeon is forced to treat the diseased bone and distraction requires caution; in the second, the elongations are significant and it is easy to cross the line when the elongated bone does not grow together or the muscles, blood vessels, and nerves are overstretched. Of course, cases of massive bone defects or requests for significant lengthening of the legs require the most time.
What distinguishes the Bliskunov method from other surgical techniques?
Bliskunov himself calls himself a student and follower of the famous orthopedic surgeon G. A. Ilizarov. He also works on lengthening tubular bones due to the formation of bone regenerate at the site of an artificially induced fracture, but his approach has a number of important differences from the Ilizarov method.
The main feature of the Bliskunov system is that the bone-fixing device is located inside the patient’s bone, and not outside. The system combines high engineering technologies, an idea of which can be formed from the points below.
- A special implanted design is used - a telescopic titanium rod with a ratcheting mechanism, which is otherwise called a distractor.
- Through relatively small incisions in the thigh, the bone is crossed with a special instrument, then the distractor is inserted into the medullary cavity.
- To install the Bliskunov apparatus in the right place, a special Bliskunov conductor is used, which crowns a number of inventions in the field of medical engineering.
- After implantation of the structure, it remains possible to manipulate it thanks to a special control mechanism. The telescopic system is pulled out by the ratchet mechanism. It is driven by specific rotational movements in the hip joint. 18–20 cycles of such movements lead to the extension of the distractor by 1 mm.
- The patient can regulate the dynamics of traction independently, following the recommendations of doctors. The design of the device allows this process to be carried out without any external energy sources, only due to a certain mechanical effect.
- Implantation of the device takes less than a week, including preliminary examination. The rest of the recovery period can be spent outside the walls of the medical facility, leading a normal lifestyle. Naturally, subject to a number of restrictions.
- After the bone lengthening process is completed, the pelvic unit and telescopic drive are removed through a small incision, thereby turning off the device.
Surgical technique
Surgical lengthening of the lower limbs is performed under general or spinal anesthesia and takes on average one to three hours.
After antiseptic treatment, an Ilizarov apparatus is installed on the lower limb and, through small (not exceeding 5 mm) incisions, the tibia and fibula are dissected (osteotomy) with further reliable fixation of the artificial fracture. Then, daily dosage correction of the limb axis (in case of curvature) or its gradual lengthening is performed. Upon completion of the correction, the device is fixed and it remains to wait for the formation of a strong bone.
Advantages of the Bliskunov method.
Due to its features, Alexander Bliskunov’s leg lengthening technique has a number of obvious advantages.
- During the operation, bones and muscles are not pierced by metal needles, which further injure the patient. The risk of infection is practically reduced to zero.
- There is no need to regularly disinfect structural elements in contact with an open wound.
- There is no need to wear bulky devices that seriously limit the patient’s lifestyle.
- The period of stay in the hospital of a medical institution is less than a week.
What, are you interested? Increasing growth while on the job is an ideal option for many. Already want to know the place where you can have this operation and its price? Read about it at the end of the article, but first, a little hard truth.
How is the device installed?
The Ilizarov apparatus can be installed on a patient only in laboratory conditions with the mandatory use of anesthesia. Using a special medical drill, the metal needles of the device are carefully inserted at a right angle into a part of the bone. The spokes are secured to each other using half rings on which movable rods are placed. The length of the rods can be adjusted by constantly setting the required distance between the spokes.
Quite often, a compression-distraction device is used to compress or distract a bone (its lengthening or compression) in orthopedic medicine. In addition, the use of knitting needles allows you to fix bone fragments in the event of a fracture. The Ilizarov apparatus helps prevent improper fusion of bones after a fracture.
Correction of arm or leg length is an area in which compression-distraction equipment is constantly used. In order to correctly install the device for effective treatment, two wires, clearly fixed to each other, are inserted into each section of the bone that can be corrected. Using movable rods and a special key, specialists can constantly adjust the distance between the spokes and guide them. By bringing the rings of the device closer together, gradual compression of the bone can be achieved. When the rings are removed, it stretches.
If the spokes of the device begin to deform, the compression force gradually decreases. It is for this reason that patients with a compression-disruptive device installed should be under constant supervision of specialists and regularly come to see a doctor for manipulations with movable rods. It is precisely such manipulations that make it possible to control the behavior of bones during treatment, promptly eliminate the possibility of displacement of fragments during a fracture, and reduce deformation.
When it comes to bone lengthening, the Ilizarov apparatus is used at different stages of treatment. Immediately after placing the knitting needles, osteometry is performed and individual bone elements are secured at the required distance. After a week of using the device, the patient is scheduled for lengthening surgery, after which the device is put back on the bone to further regulate the healing process.
What are the disadvantages?
As often happens in medicine, the advantages of any treatment method are also its disadvantages. Read below for the most typical ones for A.I. Bliskunov’s technique.
- The standard Bliskunov operation is sterile, but there is practically no real control over the condition of the device throughout the rehabilitation process.
- If the infection does affect the surgical area, there is a very high risk of serious problems, including amputation of a limb (in fairness, I will say that with almost any such surgical operation this will have extremely dire consequences).
- If there is a mechanical failure of the device, which has a telescopic structure and is equipped with a ratchet drive mechanism, then an urgent unplanned operation will be required, and the price for your increase in height will skyrocket. And not only financially, but also morally.
- Treatment that uses the Bliskunov apparatus also ends with surgery, which further traumatizes the patient and complicates the recovery process.
- There is a certain possibility of unplanned impact on the control mechanism of the implanted structure, as a result of which the optimal bone traction schedule may be seriously affected.
- For each patient, a titanium distractor is made to order, so such production requires a certain amount of time.
Preparation for lengthening of the lower extremities in a medical clinic in Moscow
A set of preoperative preparations is necessary to assess the patient’s current condition, determine possible contraindications and reduce the risk of surgical complications:
- consultations with an orthopedist, anesthesiologist, therapist;
- lab tests
- ECG;
- CT/X-ray of the chest;
- Ultrasound of the veins of the lower extremities;
- X-rays or computer topogram of the lower extremities.
You can complete all the necessary preoperative preparation at a medical clinic inexpensively and in just one visit to the clinic. Our managers will sign you up for all studies and consultations at a convenient time and day of the week.
Patient reviews and cost of treatment.
You can undergo surgery to lengthen your legs and increase your height using the Bliskunov method at the specialized Crimean Center for Traumatology and Orthopedics named after A. I. Bliskunov in the city of Simferopol. The cost of a set of events is determined individually. For example, the cost of lengthening one thigh by 4 cm will be about $8,000, the lower leg – 4,500. This is quite expensive even for wealthy people, but you must admit that sometimes a dream is not cheap.
What reviews do patients themselves write about Alexander Ivanovich’s method? As usual, the brightest and most emotional are the negative ones. There are very few positive or neutral ones. If you are interested, type “Bliskunov method reviews” into Google and see for yourself.
That's all! Now you know that there is such a progressive Bliskunov method for increasing height. Thanks for your attention and good luck!
Best regards, Vadim Dmitriev
Leg lengthening with external fixators – Ilizarov apparatus
It was with this method that the development of such an operation as leg lengthening began. Today, foreign clinics have practically abandoned this method, since it is considered quite “cruel”. Domestic specialists continue to use it to this day as the only possible way to increase growth.
How is the procedure performed?
The procedure is called compression-distraction osteosynthesis. Therapy is used to lengthen the legs or thighs, which is determined individually for each patient.
During surgery, artificial bone fractures are performed and they are fixed with an Ilizarov apparatus. The intervention lasts 2-3 hours. The operation is performed under general anesthesia and is the first stage of treatment.
A week after installation of the device, gradual lengthening of the limb begins. Every day the device is “twisted” in such a way that the limb lengthens by 1 mm. This stage lasts several months, depending on how many centimeters the patient wants to increase his height. It is important that when wearing the Ilizarov apparatus, you should move short distances using crutches.
After the desired length is reached (maximum for the thigh - 10 cm, for the lower leg - 6 cm), a period of fixation or recovery begins. At this stage, ossification of the enlarged bone process occurs. The fixation period lasts from 6 to 12 months. During this time, patients should limit physical activity and strictly follow the instructions of specialists in order to avoid a fracture.
How long does the treatment process take?
Most often, the Ilizarov apparatus is installed on the limbs, although modern medicine also allows the use of this treatment method in correcting spinal curvature and more. You will have to wear the device for a certain number of months (minimum two). The duration of wearing the device largely depends on the specific diagnosis and the complexity of bone correction. In addition, the rate at which the patient regenerates bone tissue plays a role. This process is quite individual for everyone.
In case of complex splinter fractures of the legs, sometimes the devices have to be worn for 4 months, six months, and sometimes up to 10 months. When performing orthopedic treatment with bone lengthening, it lasts more than six months.
How is the device removed?
In medical institutions, the Ilizarov apparatus can be removed quite simply. The procedure is carried out without the use of anesthesia, since it does not cause pain to the patient. The needles are carefully removed from the bone, and the remaining puncture sites are treated with disinfectants. For some time after removing the device, it will be necessary to wear bandages on the puncture sites to protect the skin from the development of inflammatory processes as a result of dust getting into the wounds.
After using the device, patients are recommended to undergo various physiotherapeutic procedures and massages for faster recovery.
