What is Limb Reconstruction?
Limb reconstruction refers to the biological correction of musculoskeletal deformity without recourse to prosthetic devices or amputation. The technique provides a lifelong biological solution to a wide range of problems but in particular those for which conventional treatment is ether too risky or not appropriate.
Commonly treated conditions include but not limited to
- Congenital Limb Deformities
- Limb Inequality
- Short Stature
- Bone Dysplasia’s
- Metabolic Bone Disorders
- Pseudarthrosis of Bone
- Fragile Bone Conditions
- Hand and Foot Abnormalities
- Acquired Limb Shortening
- Bone and Joint Deformity
- Mal and Non Unions
- Arthritis of Joints
- Bone Defects
- Chronic Bone Infection
- Joint Stabilisation and Fusions
- Short Stature
How do you assess these conditions?
If you have a condition that is suitable for limb reconstruction surgery then a comprehensive assessment is made that includes a detailed clinical examination and specialised medical imaging to assess the type of problem, quantify effect and allow solutions to be devised that suit the individual.
This initial assessment may also include
- EOS examination
- Gait Analysis
- 3D Modeling
- Referral to other specialists
Every patient is unique and there is usually more than one solution to their problem.
How do you treat these problems?
Limb reconstructive techniques aim to replace, realign or lengthen bones and joints into the correct mechanical position so as to improve pain, function and look of the limb. It may be combined with tendon or muscle surgery to improve strength and balance or be part of a program of treatment.
Bone is a unique tissue that has the ability to heal without scar formation and act as a potentially limitless source of new tissue. This means that it can be straightened, lengthened and even transported using both internal and external devices.
External fixators are devices that can be attached, via screws and wires, to the skeleton to move joints or bones into new positions. There are many types of devices that are used for specific indications but usually classified as either being a ”rail’ or “circular” device. The original circular device had now become a sophisticated and powerful tool for Limb Reconstruction Surgeons with the introduction of the computer assisted hexapod type frames that allow multiplane corrections to be performed with the single device.
Internal devices has the distinct advantage that the patients does not have to “wear” a frame and that there are no pin sites in the skin, muscles are not tethered and day to day activities are much easier. Plates can be used to hold the bone in a corrected position whist healing occurs and while rods placed inside the bone can do a similar thing they can also be used to perform an internal lengthening or bone transport.
Success of operative treatment depends on a coordinated process that includes preoperative assessment, careful planning, preparation for surgery and a complete postoperative program. Limb reconstruction is stressful for both patient and staﬀ, complex in its application and requires a greater degree of patient supervision than conventional orthopaedic surgery.