Lengthening plan for Achondroplasia is different from that of short stature normal people. In Achondroplastic the patients soft tissues are more elastic and the bones are the only short element. This gives us as limb lengthening doctors to lengthen them successfully for a longer distance. Our aim is not to lengthen them but to them become as normal as other people. This is impossible, but only to allow them to do what other short stature people can do (people over 140 centimeters ). Our aim is to have a functionally well individual in the community. If the Achondroplastic person become as close as possible to 150 cm., so this is a great success. He or she will be able to do the things that other people are doing activities as normal as driving a regular car, using the public phones, ability of closing or opening a window….etc
The best age to start lengthening in Achondroplasia is about 7 to 8 years. Any leg deformity could be corrected simultaneously with tibial or leg lengthening for about 10 centimeters. 2 years later both Femora thighs bones could be lengthened (for about 10centimeters). 2 years later again, both humeral bones or arms can be lengthened for the same previous amount. Every lengthening operation the patient can get between 10 to 12 centimeters of lengthening.
2 years later after the first lengthening procedure in the same bone segment, the process could be repeated to gain more height. At the age of 14-16 years the Achondroplastic person now will have at least 30 centimeters more than the height he was going to reach without lengthening procedures.
Dr. Elbatrawy is using a new software to calculate the exact height that normal or Achondroplastic person will have at age of puberty ( if he or she does not have any operation ) so, it is easier to plan about how many centimeters this person needs for lengthening and divided on how many operations till age of puberty.
It is very possible to lengthen Achondroplasia or short stature patients at any age later on in their life.
Usually, during the first time patient evaluation, we use a special chart ( now a special software ) to detect the height to the patient will reach after he or she reach puberty. Based on this information we start plan for lengthening procedures.
The procedure is not only helpful in giving height increase, but also for correction of bowing and other deformities commonly associated with achondroplasia , achondroplastic dwarf, chondrodysplasia, epiphysial or metaphysical dysplasia and physeal dysplasia.
Lengthening could be achieved using different methods. We choose the one suitable to the patient. Commonly used devices are Ilizarov ring external fixator and Orthofix. We prefer using Orthofix device for the humeral ( arm ) and Femoral ( thighs ) lengthening.