Prior to undertaking a Limb Reconstruction and Lengthening procedure, there is a definite path that needs to be followed.

Education:

As part of the education process, the child and family will meet with the Orthopaedic and then Multi - disciplinary team.

The Orthopaedic team consists of:

• A/Professor Leo Donnan -Consultant Orthopaedic Surgeon
• Mr Chris Harris - Consultant Orthopaedic Surgeon
• Ms Cheryl Dingey - Nurse Co-ordinator 
• Mr Greg Cull  - Physiotherapist
• Ms Erin Lowrie  - Occupational Therapist
• Mr Hamish MacLeod - Educational Consultant
  

It is the nurse co-ordinator's role to facilitate all education and preparation of the patient for surgery.

As part of the preparation, each child will attend the Limb Reconstruction Clinic.

This involves a through assessment of the child's affected limb and a full examination of their walking

Clinical photographs may also be taken at this point. Further to this appointment, other investigations may be ordered.

Copies of all education brochures will be provided at this visit, if not already given to the family.

Radiographs:

These must be completed prior to the child progressing to theatre. This is to allow the surgeon time plan out the procedure in advance, and to pre-order any specific equipment or stock if needed.

Clinical Photographs:

Clinical Photographs are a permanent record of the child's progress through the Limb reconstruction phase. Pre-operative photos serve to remind both the team and the child/family what the deformity looked like before. Progress photographs are often a useful tool also, to map the changes occurring. These may be done via Digital file or in the hospital photographic studio: in all cases an informed consent must be obtained. It is suggested that a photograph of the consent form also be taken prior to each group of photos being taken.

Physiotherapy Assessment:

A detailed examination of each child is required. It is suggested that a standard examination form is developed to ensure that each child has the same examination performed and these are stored by the assessor and added to at each visit. A copy should also be filed in the patient's Medical record.
Continued record keeping of assessment is vital to detect even slight deterioration in the patient's progress, which in turn means that quick action is possible.

An individual program is developed for each child in the rehabilitation phase.