Limb lengthening and limb correction are surgical procedures that can help to correct the results of irregular bone growth that occurred in childhood, or help to repair the damage caused by an accident. In these procedures, the bone is carefully cut apart and then slowly lengthened through the growth of new bone. Angular correction can often be accomplished in this same process.

The history of limb lengthening began in the 19th century with surgeons who were dedicated to overcoming the issues of limb discrepancies and of short height. Limb lengthening science did not flourish however, until the 20th century, when Siberian surgeon G. Ilizarov discovered the phenomenon of distraction osteogenesis - the ability of bone to regenerate - to grow to fill a void created by trauma or surgery. Ilizarov invented an external fixation device for lengthening and changed lives of untold thousands of patients.

Parallel to the development of external fixation, internal fixation methods were investigated and implemented into clinical practice for the treatment of bone fractures. In 1939, German surgeon Gerhard Kuntscher performed the first surgery using an intramedullary nail. An intramedullary nail is a one piece rod that is inserted into the hollow canal of a bone to provide stabilization.

Internal fixation methods used for fractures were also applied to limb lengthening, and a new the generation of intramedullary nails and intramedullary lengthening devices came into practice. Some internal devices were able to reduce scarring, reduce pain and reduce the risk of neurovascular damage. In addition, the internal devices were often more comfortable to the patient in other aspects of everyday life.

The ISKD intramedullary lengthener is the most advanced internal lengthener to date. The ISKD works in synergy with the body's natural bone healing process to achieve lengthening. It is designed to lengthen for a predetermined distance, and then stop. During the last three years more than 250 patients have been treated using this device with great success. Many of these patients have lengthened with minimal or minimized pain, and with a low risk of infection. They have not experienced unwanted attention while in public, and have enjoyed the ability to sleep in a normal fashion.

The ISKD has been shown to advance the surgical method of limb lengthening, the lengthening mechanism, the monitoring of bone growth, and the patient's quality of life.

How does it the ISKD work?

The ISKD is a two-part metal rod. The distal (nearest the foot) part is nested inside the proximal (near) part. During surgery, the surgeon will first separate the bone to be lengthened into two halves by cutting it somewhere near the middle. This is called an osteotomy. The ISKD is implanted within the bone, and its two parts separate, or distract, over time as the patient moves. When the device distracts, it creates a growing distance between the two halves of bone and encourages new bone to grow in the space.

Muscles, skin and other soft tissues will adapt as the limb slowly lengthens. The ISKD procedure is completely internal or "closed." There are no external devices, wires or pins needed to lengthen your bone.

The surgical insertion of the ISKD lengthener into the hollow canal of the bone, called the intramedullary canal, takes approximately two hours, and is accomplished while under general anesthesia. The lengthener is inserted into the bone through a hole drilled just beneath the knee for tibial lengthening and just below the hip for femoral lengthening.

Two screws secure the lengthener in position to the proximal piece of the bone and another two secure it to the distal portion. The bone is cut in the middle prior to the insertion of the lengthener. If the tibia is being lengthened, an opening will be made in both the tibia and the fibula, a smaller adjacent bone. With the ISKD device in place, lengthening is ready to take place.

The lengthening of bone occurs in two phases: the Distraction Phase, and the Consolidation Phase. During the Distraction Phase, the two segments of your bone are being moved away from each other, and the space between them is filling with new soft bone. The Consolidation Phase is the time during which the newly created bone solidifies enough to support your weight.

Once the patient has attained their limb length goal, the new bone must calcify and harden into bone. This will generally take three to nine months depending upon the amount of distraction that occurred during the lengthening process. The longer the distraction, the longer the consolidation may take.

The ISKD is an advanced solution for bone lengthening that provides less pain, scarring and psychological stress for patients, both young and old. For more information, please visit our patient education and information website at www.iskd.com