Proven, Innovative Treatment for Your Child With a Limb Length Discrepancy
Physical therapy combined with an external fixator (EXFIX) can help create the best quality of life for a child with a limb length discrepancy.
The process begins during limb lengthening surgery with what's called an osteotomy, during which a skilled Shriners Children's orthopedic surgeon cuts the bone to be lengthened. The surgeon then stabilizes the limb using one of several different external fixation devices, called frames. The device has small rods, called pins, that go through the skin and into the bone.
This treatment is most commonly used on legs, but in some circumstances it can be done on arms as well.
Parents Participate in After-Care
After surgery, parents take an active role in their child's rehabilitation. The external fixator has has adjustable bars, called struts, that you will turn to slowly lengthen the bone. These small turns gradually and carefully lengthen the gap between the two sections of the bone that was cut during surgery. New bone grows in the middle as the gap widens.
This personalized treatment is combined with physical therapy, led by one of our skilled therapists. They work hand-in-hand with you and your physician to develop a care plan personalized for your child's needs. Coordination is easy because the entire team works under the same roof. This also means you don't have to drive to multiple locations for your child's treatment. You will be taught your child's therapy routine so you can help at home between appointments.
Therapy begins just one day after surgery for most children and combines stretching and strengthening exercises.
Though this sometimes can be a years-long process, what you will find here at Shriners Children's is a family – both in your medical team and with parents and children who are at different points along the same path you now walk.
Specific treatments and services may vary by location. Please contact a specific location for more information.
Common Questions Kids Ask
Initially after surgery, kids may feel afraid to move the limb with the external fixator. As the lengthening process begins, their muscles will tighten and weaken somewhat. This is to be expected. The goals of physical therapy are to help keep the child's muscles flexible and strong, and to help them stay as active as possible throughout the rehabilitation process.
Here are some answers to common questions and concerns your child may have:
When does physical therapy start? Physical therapy will begin the day after surgery. Your physical therapist will provide your child with an exercise program that you will help your child perform in their room on weekends. Most kids are able to go home the Monday following surgery.
It it seems too difficult... At first, your child may need help moving their limb in bed. If it involves their leg, this will include standing and taking a few steps with a walker or crutches. Your child likely will require a wheelchair to get to physical therapy. This is perfectly normal and you will work with your child to help them regain their independence. Most kids are up and walking with a walker or crutches by the time they leave the hospital, using a wheelchair only for long distances outside of the home.
How does physical therapy work? While in physical therapy, your child will work on strengthening and stretching exercises. Your physical therapist will provide an exercise program designed specifically for your child and will make recommendations on whether a walker, crutches or cane is best for them. If your child is able, your therapist will teach them how to walk up and down a small flight of stairs in the physical therapy department as well. Things may go slowly the first day or two, but it will get easier.
Will I have to do this at home? Before your child leaves the hospital, your physical therapist will ask you to demonstrate that you're comfortable assisting your child with their home exercise program and supervising them while walking. You'll also be asked to show that you can adjust your child's external fixator. You will be given a written copy of your child's home exercise plan, including your therapist’s contact information in case you have any questions after you leave. It is very important that you encourage your child to continue to perform their exercise plan as instructed and follow all therapy instructions. This is the proven method to give your child the best quality of life.
The care, support and devotion Marie Eva received from Shriners Children's was never interrupted.