Quadrilateral Limb Lengthening Surgery

Cross-lateral tibia-femur lengthening is performed if the goal of lengthening is more than 6-7 cm. It is a two-stage procedure. This is because although the simultaneous lengthening of tibias is a relatively easy procedure for patients, the bulkiness of the Ilizarov/hybrid frame makes simultaneous femur lengthening very uncomfortable, and nearly impossible for the patient. That is why we lengthen one tibia and one cross lateral (opposite) femur in the first stage. After the first period of extraction, the length of the legs is the same, but the knee joint level is different.

Intramedullary nails are inserted in with three external rings. Distraction starts as usual on the 5th day after the surgery. When the necessary length of the segments is achieved and X-ray control reveals adequate bone formation, the second surgery is performed to put in locking screws, remove the frames. In the same surgery, intramedullary nails are inserted in opposite tibia and femur with three external rings.