Osteoplasty, femur; lengthening
CPT4 code
Name of the Procedure:
- Common Name: Femur Lengthening Surgery
- Technical/Medical Terms: Osteoplasty, Femur; Lengthening
Summary
Femur lengthening surgery is a procedure designed to increase the length of the femur (thigh bone). This is achieved by surgically cutting the bone and using specialized equipment to gradually stretch it, promoting new bone growth.
Purpose
The procedure addresses conditions such as leg length discrepancy or congenital deformities that result in one leg being shorter than the other. The primary goal is to achieve equal leg lengths, improve mobility, and enhance the patient's quality of life.
Indications
- Significant leg length discrepancy (LLD)
- Congenital deformities
- Post-traumatic bone shortening
- Conditions such as Achondroplasia
- Patients who experience pain, discomfort, or functional limitations due to LLD
Preparation
- Fasting for 8-12 hours prior to the procedure
- Discontinuation of certain medications as advised by the doctor
- Pre-operative imaging studies (e.g., X-rays, MRI)
- Blood tests and a physical examination
Procedure Description
- Anesthesia is administered to the patient (general or regional).
- A surgical cut is made on the femur.
- The femur is divided carefully using surgical tools.
- An external or internal fixation device is attached to the bone.
- The bone is gradually pulled apart (distracted) over weeks to promote new bone growth.
- Regular follow-up visits to adjust the device and monitor bone growth.
Duration
The operative part of the procedure typically lasts 2-3 hours. The entire lengthening process can take several months, depending on the extent of lengthening required.
Setting
The procedure is performed in a hospital operating room, with an inpatient stay for initial recovery.
Personnel
- Orthopedic Surgeon
- Anesthesiologist
- Surgical Nurses and Technicians
- Physiotherapist for post-surgical rehabilitation
Risks and Complications
- Infection
- Nerve or blood vessel damage
- Blood clots
- Bone healing issues (malunion or nonunion)
- Pain and swelling
- Device-related complications (loosening or failure)
Benefits
- Equalized leg lengths
- Improved gait and mobility
- Reduced pain and discomfort
- Enhanced functional outcomes and quality of life
Recovery
- Initial hospital stay of several days
- Pain management with medications and physical therapy
- Avoid weight-bearing activities for several months
- Gradual increase in activities as per doctor's guidance
- Regular follow-up appointments for device adjustments and monitoring bone growth
- Full recovery can take 6-12 months, with continuous physiotherapy and rehabilitation
Alternatives
- Shoe lifts or orthotic devices (less invasive with fewer risks but may not be sufficient for significant discrepancies)
- Epiphysiodesis (stops growth in the longer leg; suitable for children still growing)
- Lengthening surgery for other bones
Patient Experience
During the procedure, the patient is under anesthesia and will not feel pain. Post-operatively, they can expect soreness and discomfort, manageable with pain medications. The lengthening process involves minor daily adjustments that might cause temporary discomfort. Physical therapy will help regain strength and mobility.