Your goal in the lengthening journey is simple: steady, predictable, and safe progress. The key is recognising common risks early and turning small, protective habits into a daily routine. Below is a patient-friendly guide with practical steps you can use today.
Important: This is general guidance. Your personal plan depends on your device (internal nail / external fixator) and your risk profile. Always follow your surgeon and physiotherapist’s protocol.
Why it matters: Surgery and immobility increase clot risk. Red flags: calf pain/swelling or warmth on one side; shortness of breath or chest pain require urgent medical attention.
Daily prevention: Early mobilisation, ankle “pump” exercises, good hydration, compression stockings if prescribed, and full adherence to blood thinners. Avoid long, still periods and leg-crossing for extended times.
How it develops: Especially with tibial lengthening, gastro-soleus tightness and loss of ankle dorsiflexion create toe-walking.
Prevention: Daily pain-free active motion and gentle, sustained stretching; night splints/AFO if advised; considered heel-lift strategies; progressive heel-raise work in physiotherapy. At early warning (difficulty heel-strike, persistent calf tightness), review protocol and adjust lengthening rate promptly.
Watch for: Tingling/numbness on the top of the foot, tightness along the outer knee (peroneal nerve), weakness or new difficulty lifting the foot.
Prevention: Individualise lengthening speed, avoid extreme end-ranges, add nerve-glide drills, optimise sitting/sleeping positions. Report new or worsening neurological symptoms immediately.
Risk: With femur lengthening, loss of full knee extension; with tibia lengthening, loss of ankle dorsiflexion. Long periods with the knee flexed or ankle fixed feed stiffness.
Prevention: Short-frequent ROM sessions, gentle hamstring/hip-flexor stretches, patellar and soft-tissue mobilisation; coaching for graded loading + clean gait mechanics. When resting, support the knee in full extension as directed.
What happens: Over-rapid distraction can weaken regenerate; too slow can lead to premature consolidation.
Prevention: Radiograph-guided rate–rhythm adjustments; stop smoking; adequate calories/protein and clinician-guided D/K2/calcium strategy; physiotherapy to coach correct weight transfer.
Signs: Redness, warmth, tenderness, discharge. Prevention: Meticulous daily care, shower/dressing protocol, reduce clothing friction. Report changes early—prompt antibiotics often suffice.
Daily care: Intermittent cold, elevation, appropriate compression; hydration and protein; consistent sleep. You’re not alone—your team (and psychological support when needed) sustains motivation and adherence.
Let’s map your personal risk plan. Share your device type, activity level and goals—receive a written daily prevention routine and early-warning playbook within 24 hours.
Sedat Duman, MD
With years of experience, Time To Be Taller serves its patients in its clinic located in Mall of Istanbul.
