Achondroplasia
Clinical Condition
A 14-year-old female patient had disproportionate short stature with an initial height of 128 cm due to achondroplasia, causing handicap in many activities of daily living. Thus, there was a medical indication for bilateral leg lengthening. For reasons of proportionality, so that the new leg length would be in harmony with the torso and arms, the patient opted for a 12 cm increase in height.
Disproportionate short stature in achondroplasia
Short upper and lower legs and deformed joints
Treatment
The costs for a bilateral leg lengthening were covered by public health insurance, as there is a medical indication for short stature due to illness.
In order to remain independently mobile during the entire treatment, each leg was treated separately in a staged fashion. During the first stage, the left leg was lengthened with a FITBONE distraction nail in the left upper and lower leg. The temporary difference in leg length was easily compensated for with a shoe elevation. After adequate bone healing of the left leg, the same procedure was carried out on the right leg 7 months later. Routine and regular self-exercise and nightly positioning in a plastic splint during lengthening improved mobility and prevented knee joint contractures.
At the end of leg lengthening on the left side
Intramedullary distraction nails in the left upper and lower leg
Result
After completion of the treatment with a 12 cm lengthening, both legs were the same length and straight, the joint ranges of motion were within normal on both sides. The patient's height was now 140 cm and with slightly elevated shoes she was able to cope well in daily life without any restrictions.
Harmonious proportions after leg lengthening on both sides
Straight legs of equal length after 12 cm lengthening
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