Dr. Podeszwa explains intramedullary lengthening.

Aug 17, 2018 / Limb Lengthening

#SRHaccess Facebook LIVE Recap: Limb Lengthening - Intramedullary Lengthening

On this week’s Facebook live, Co-director of the Center for Excellence in Limb Lengthening David A. Podeszwa, M.D. joined us to discuss intramedullary lengthening – a form of treatment for our limb lengthening and reconstruction patients.

Watch the Facebook live.

What is intramedullary lengthening and how does it work?

  • It is a technique of lengthening the bone that uses a rod that is surgically planted inside the bone, lengthening it over time using a magnet or an electrical current.

When is intramedullary lengthening used as a treatment plan?

  • Ideal for patients who have a leg-length discrepancy over 4 or 5 centimeters at the time that they’re done growing.
  • Intramedullary technique works better in patients who have straight bones

What’s the difference between the external fixators and intramedullary rods?

  • Usually, an intramedullary rod is preferred over an external fixator. 
    • Quality of life is better for patients with intramedullary rods.
    • Less pain for the patient, and less care required with intramedullary rods.

Different types of intramedullary rods:

  • Magnetic rod – a magnet slowly lengthens the rod inside the bone
  • Electrical current – a small transducer sends an electrical current that slowly lengthens the rod.

How long do patients stay in the hospital after one of these rods is implanted?

  • A majority of the time the rod goes in and the patient will go home the next day. 
    • We wait anywhere from 5-14 days after the rod goes in before we start lengthening process in clinic.

How long does the lengthening process take?

  • It’s going to be at least between six and nine months. 
    • The bone will lengthen about a millimeter a day, and every centimeter of lengthening requires about a month of healing.

Multidisciplinary approach:

  • A child whose limb length difference is over two inches requires a team of experts to guide the patient and their family through the six- to nine-month process.
  • Working as a team: before a surgery date is set, the patient and their family meet with multiple departments within the hospital.
    • Physicians meet with fellow physicians to discuss the treatment plan.
    • Patient meets with the nursing team to discuss education regarding the procedure and what to expect.
    • Our psychology team meets with the patient and family to help them understand the treatment and how to cope with the before and after stages.

At what age our patients a candidate for an intramedullary rod?

  • Patients become candidates when they are 8, 9 or 10 years old, depending on the deformity. 
    • In most cases, it is best to wait until the patient is done growing.

What’s the activity level allowed during this process?

  • Once the lengthening process begins, the patient will be on crutches until the lengthening process is complete and the bone has healed enough to walk on it again. 
    • Between the daily physical therapy and the extended time on crutches, the patient is the most important part of the lengthening process.

Final thoughts about limb lengthening:

  • As the technology improves, it will open a lot of doors for patients.
  • In the end, treating the difference is to improve the patient’s life, but not define their childhood.

Our experts are here for the patient and their family every step of the way.  Have more questions about limb lengthening?  Email askadoc@tsrh.org.

Learn more about limb lengthening and the research our hospital is conducting.

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