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What is Limb Reconstruction

  • “Limb Reconstruction” refers to the subspecialty of orthopaedic surgery that deals with problems in which a limb is the wrong shape or length, and function is affected.  Limb Reconstruction (LR) surgeons use a variety of techniques to improve the length, shape, and function of a limb, by re-aligning bones, correctly positioning or stabilising joints, and sometimes making bones longer. 

    When a limb has a different shape due to a problem with a bone or joint, this is called a ‘deformity’. A deformity may be one of angulation, rotation, translation, or length. Part of the intricacy of Limb Reconstruction is working out the exact nature of the deformity, and the impact it is having on function. A deformity may be "congenital", meaning it is present at birth, or arise later, hence "acquired".

    Patients with many different conditions are treated by Limb Reconstruction techniques, including patients born with fibula hemimelia, congenital short femur, and congenital tibial pseudarthrosis, patients with bone dysplasias such as achondroplasia or fibrous dysplasia, and patients who have suffered trauma (broken bones) or bone infections which may have affected the  growth of that bone. Conditions such as club foot (CTEV) and joint stiffness (“contractures”) caused by spina bifida or arthrogryposis may also be treated. 

    Some deformities can be corrected quickly, for example by cutting the bone, aligning it properly, and fixing it with a plate and screws. Some deformities require gradual correction, and an external fixator may be used. An external fixator is a metal frame outside the limb, that is attached by screws or wires that run through the skin. Small adjustments can be made to the fixator, hence slowly moving the bones underneath.  

    Making bones longer (“limb lengthening”) must be done gradually. This can be done an external fixator, or sometimes by the use of a motorized nail that lies inside the bone.

    LR techniques have a broad range of applications, including use in reconstruction post tumour surgery.