Limb lengthening surgery is a complex procedure that involves breaking and gradually separating bones to increase a person’s height. However, there are age limits to consider when deciding whether this surgery is appropriate. In this article, we’ll discuss the upper and lower age limits for limb lengthening surgery and what factors are considered when determining these limits.
Key Criteria Determining Age Limits for Limb Lengthening Surgery
Growth Plate Status: The closure of the growth plates (epiphyseal plates) is crucial in determining the lower age limit. Surgery is typically not recommended until the growth plates have closed, usually around ages 17-18.
Bone Quality and Density: Bone quality and density are key factors, particularly for the upper age limit. As age increases, bone density and the rate of new bone formation generally decrease, impacting the success of the surgery.
Overall Health and Chronic Disease: The patient’s general health, including any chronic diseases, plays a significant role. Chronic conditions may complicate the surgery and recovery process, especially in older patients.
Bone Formation Ability: The body’s capacity to generate new bone tissue is essential for successful limb lengthening. This ability diminishes with age, affecting the upper age limit.
Soft Tissue Lengthening and Healing Capacity: The ability of soft tissues (muscles, tendons, and ligaments) to stretch and heal properly after surgery is crucial. Younger patients generally have greater flexibility and healing capacity, which can impact the success of the procedure.
Chronic Disease: The presence of chronic diseases, such as diabetes, osteoporosis, rheumatoid arthritis, and cardiovascular conditions, can impact both the surgery and recovery process. These conditions may hinder healing, increase the risk of complications, and affect overall outcomes, especially in older patients, making them critical factors in determining the suitability of the surgery.
Lower Age Limit for Limb Lengthening Surgery:
To determine the lower age limit for limb lengthening surgery, doctors evaluate whether the growth plate is closed. The growth plate is a disc-shaped region consisting of cartilage near the epiphysis, which plays a role in the growth of long bones. Height growth varies from person to person, but generally stops at the age of 17-18 when the growth plate closes. However, if the growth plate is not closed, height growth may continue until the age of 25. Your orthopedic surgeon can use X-ray imaging to determine whether your growth plate is closed. It is not recommended to perform limb lengthening surgery on young people whose height is still increasing. If you still find your height short after waiting for the growth plate to close and your height to stabilize, you may consider limb lengthening surgery with your surgeon’s approval. Therefore, the lower age limit varies from person to person, but the average age is 18.
Upper Age Limit for Limb Lengthening Surgery:
The upper age limit for limb lengthening surgery is determined by the quality of your bones and your ability to form new bone tissue. After puberty, bone quality and the rate of new bone formation decrease with age. In limb lengthening surgery, bones are gradually separated by 1 mm per day, and your body must form dense bone tissue to fill the gap. If your ability to form new bone tissue is low, this bone union does not occur successfully, leading to nonunion, one of the most significant complications of limb lengthening surgery. In addition, soft tissues such as muscles, nerves, tendons, veins, and fascia need to grow and develop along with the bone. Therefore, the body's anabolic activity must be high. You should not have chronic diseases such as diabetes, hypertension, or heart disease, as these conditions can complicate both the surgery and recovery process. To determine whether you are suitable for limb lengthening surgery at an advanced age, you should undergo bone density, bone quality, and bone mineral density tests, along with a general health check-up. Share these test results with your doctor and listen to their recommendations. If you have low bone density or quality, limb lengthening surgery may be risky for you. However, even in such cases, the lengthening amount and speed can be adjusted, and some people can successfully undergo limb lengthening surgery with a good nutrition program and intense exercises. Limb lengthening can be performed safely at older ages by setting a lower maximum lengthening target and decreasing the daily lengthening rate. Although it varies from person to person, the average upper age limit can be set at 55.
Conclusion:
Limb lengthening surgery is a complex procedure that requires careful consideration of age limits. If you’re considering limb lengthening surgery, you should consult with an orthopedic surgeon who specializes in this procedure. Keep in mind the lower and upper age limits, and ensure that your bones, soft tissues and overall health are healthy enough to undergo the procedure. By following these guidelines, you can increase your chances of a successful outcome.