Limb Lengthening & Reconstruction
- About Us
- Our Care
- What to Expect
Transforming Lives Through Innovative Care
At Nemours Children’s, we know that limb differences — problems with legs, feet, arms, hands or hips — can impact a child’s life in many ways. Beyond physical challenges, limb differences can affect emotional, mental and social well-being, and overall development. That’s why we bring together a whole team to care for your child, supporting your family from the start.
Our team is part of prestigious, award-winning pediatric orthopedic centers in Delaware and Florida. Here, internationally recognized orthopedic surgeons use innovative limb preservation, lengthening and reconstruction methods and technologies. From advanced 3D EOS imaging and surgery planning to the latest fixation devices and custom prosthetics, your child gets the highest level of care available.
Families from around the world come to Nemours for our vast experience treating even the most complex limb conditions. We know how children grow and plan treatment around development. Our team researches limb disorders, and creates devices and therapies to help kids function to their highest ability. We share what we learn with our peers and help to set the standard of care for kids everywhere.
Your child’s care team includes skilled advanced practice providers, nurses, rehabilitation therapists, child psychologists, social workers, Child Life specialists and many others who know how to help kids with limb differences heal, build confidence and grow strong.
Two Leading Pediatric Orthopedic Centers
Nemours provides advanced care for newborns, children and teens with the full range of orthopedic conditions, including complex spine disorders, neuromuscular conditions, sports injuries and rare disorders affecting bone growth. Learn more about our extensive care and research.
“I have qualified for [state championship swimming] both my freshman and sophomore year amongst able-bodied swimmers.”
“It hasn’t been an easy road for him, but his incredible progress wouldn’t have been possible without the unwavering support he received.”
“A family friend suggested Nemours, and from the moment we walked through the doors, we knew we were in good hands.”
“I don’t know where Alex would be without Dr. Loveless. We really got lucky when we found Nemours.”
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Expert Limb Lengthening & Reconstruction in Florida
Our Florida limb difference and reconstruction specialists partner with your family to identify goals and tailor a treatment plan to meet them. Whether your child was born with a limb difference or developed the condition from an injury or disease, you can trust our expertise.
Our pediatric Orthopedic Center is ranked among the best in the nation by U.S. News & World Report. You get the highest level of care here.
We offer advanced, coordinated care at our Limb Reconstruction & Lengthening Center in Orlando. We also offer video visits.
We offer advanced EOS imaging with low dose radiation and 3D modeling for safer long-term monitoring and more precise diagnosis and treatments.
Your child’s care is informed by active research, and we share our expertise with the medical community.
We’ve created a vibrant community of support, connecting families along the same journey for inspiration, hope and shared learning.
Meet Our Florida Pediatric Limb Differences Team
Our specialists are at the forefront of their fields. They work tirelessly to improve the quality of life for children and teens with limb differences.
Limb Reconstruction & Lengthening Center, Central Florida
The Limb Reconstruction & Lengthening Center in Central Florida is based at Nemours Children’s Hospital, Florida in Orlando. Our team is internationally recognized for performing highly complex, innovative procedures. Families come here for complete care that’s coordinated and convenient. We offer everything all in one place.
Expert Limb Lengthening & Reconstruction in Delaware
Our Delaware Valley limb differences and reconstruction specialists partner with your family to identify goals and tailor a treatment plan to meet them. Whether your child was born with a limb difference or developed the condition from an injury or disease, you can trust our expertise.
Our Orthopedic Center is ranked among the top 10 in the country by U.S. News & World Report. You get the highest level of care in one place.
We’re home to the first pediatric gait and motion analysis lab of its kind, providing precise diagnosis and treatments.
We offer the latest advancements in limb lengthening and reconstruction and enhanced recovery programs that help kids heal after orthopedic surgery.
Your child’s care is informed by active research, and we share our expertise with the medical community as educators and speakers.
We’ve created a vibrant community of support, connecting families along the same journey for inspiration, hope and shared learning.
Meet Our Delaware Valley Pediatric Limb Differences Team
Our specialists are at the forefront of their fields. They work tirelessly to improve the quality of life for children and teens with limb differences.
Unique Programs Focused on Healing
Nemours Orthopedic Center in Delaware Valley offers Enhanced Recovery After Surgery (ERAS) for kids recovering from orthopedic surgery. This evidence-based program focuses on enhancing safety, healing and outcomes through every stage of your child’s surgical journey.
ERAS includes principles that reduce surgical stress, limit opioid use for pain, and promote early movement after surgery. We use methods like regional anesthesia, minimally invasive surgical approaches and nutrition to build strength and support healing. ERAS often means shorter hospital stays, reduced complication rates and quicker return to normal activities.
Expert Limb Lengthening & Reconstruction at Nemours
Our limb differences and reconstruction specialists partner with your family to identify your goals and tailor a treatment plan to meet them. Whether your child was born with a limb difference or developed the condition from an injury or disease, you can trust our expertise.
Our Orthopedic Centers are ranked among the best by U.S. News & World Report. You get the highest level of care, and everything your child needs, in one place.
We offer advanced EOS imaging featuring low dose radiation and 3D modeling for safer long-term monitoring and more precise care.
We provide the latest advancements in limb lengthening and reconstruction.
Nemours is actively researching limb differences, and we share our expertise with the medical community as educators and speakers.
We’ve created a vibrant community of support, connecting families along the same journey for inspiration, hope and shared learning.
Meet Our Nemours Pediatric Limb Differences Team
Our specialists are at the forefront of their fields. They work tirelessly to improve the quality of life for children and teens with limb differences.
Programs & Services
Nemours provides the full range of nonsurgical and surgical care for children with limb problems, including limb deformities, limb length differences and limb discrepancies (missing bones or parts of limbs).
We customize our approach to each child’s needs, and your goals and wishes. We help you weigh the risks and benefits. We give you all the information you need to make informed decisions for your child and family. As a team, our focus is helping your child live a full, active life.
Highlights of our care include:
- Coordinated care led by a nurse trained in limb differences to help families navigate the journey from diagnostics to surgery and beyond.
- Advanced medical imaging, including state-of-the-art low dose, 3D EOS imaging, CT and MRI.
- Perinatal and fetal diagnosis and treatment planning before your child is born.
- Gait and motion analysis testing in Delaware, providing the gold standard for the most precise diagnostics, surgical planning and orthotics/prosthetics design.
- Genetic testing if needed to identify underlying causes of congenital (present at birth) limb differences.
- Team-based collaboration among specialists who are experts in complex orthopedic conditions such as skeletal dysplasia, hip disorders, hand and upper extremities, lower extremities and foot and ankle differences, to develop the best treatment plans for your child.
- Nonsurgical orthopedic treatments, including rehabilitation therapies, orthotics and prosthetics (on-site at our children’s hospitals), adaptive equipment and more.
- Innovative surgical options, including limb lengthening, limb reconstruction and microsurgery (on the nerves), using the least invasive approaches possible.
- Pain management programs with specialized methods for recovery and rehabilitation.
- Nutrition counseling to help your child gain health and build strength and endurance.
- Psychosocial support from child psychologists who counsel and empower your child to be resilient and confident as they grow.
- Support services from a whole team to help find resources, coping support, financial assistance and more.
- Ronald McDonald Houses nearby for budget-friendly family lodging.
- Services for international families, including assistance with planning and travel, language and cultural support and more.
Limb Reconstruction & Lengthening Surgery
Our orthopedic specialists have subspecialty training and expertise in correcting complex deformities in the upper extremities (arms, forearms, hands and fingers) and lower extremities (thighs, legs, feet and toes), lengthening upper and lower limbs, and reconstructing hip, knee and ankle joints.
Limb Lengthening Procedures
These surgeries increase the length of a limb that is shorter than another, and may include:
- External fixation lengthening, using devices outside the body to gradually stretch the bone.
- Internal fixation lengthening, using a rod inside the bone (called intramedullary or IM fixation) or plates and other devices attached to the outside of the bone (called extramedullary or EM fixation).
Deformity Correction
These procedures correct abnormal bone shapes or alignments, and may include:
- Acute deformity correction, which is immediate correction using internal or external fixation.
- Gradual deformity correction, or a slow adjustment over time
Comprehensive Reconstructions
These complex procedures address many aspects of severe limb differences. Examples include:
- Super knee reconstruction to rebuild the knee joint and surrounding structures.
- Super ankle reconstruction to rebuild the ankle and foot.
- Rotationplasty to repurpose part of the leg to function as a knee joint.
Hip & Pelvis Procedures
These surgeries address issues in the hip joint and pelvic area, and can include:
- Femoral head osteotomy, or reshaping the top of the thighbone (and sometimes used with surgical hip dislocation)
- Triple pelvic osteotomy, or realigning the pelvic bones (often combined with femoral head procedures).
Upper Limb Procedures
These include specific techniques for arm and hand differences. For example, ulnarization for radial club hand, which corrects a hand difference where the forearm bone (called a radius) is underdeveloped.
You can learn more about limb differences and limb length discrepancy from the experts at Nemours KidsHealth®.
Conditions & Treatments
We see many conditions related to limb differences — far too many to list here. The conditions we treat vary depending on the location and providers selected. Don’t see a condition listed? Call us.
Related Specialties & Programs
Care for International Families
Families from across the globe choose Nemours Children’s Hospital, Florida for care and surgery not available at home. Our team understands your unique needs and works hard to remove barriers so your child can get the right care, right here.
We help with everything, from connecting you to local accommodations, places of worship and interpretation services, to coordinating follow-up care in your own country. We partner with your family and providers to provide the best possible outcomes, no matter where you call home.
Care That Goes Beyond Medicine
At Nemours, our care for children and families goes well beyond medicine. We offer an array of support services and programs aimed at building strength physically, mentally, emotionally and socially. We help your whole family from the start and stay with you throughout the journey.
Care for International Families
Families from across the globe choose Nemours Children’s Hospital, Delaware for care and surgery not available at home. Our team understands your unique needs and works hard to remove barriers so your child can get the right care, right here.
We help with everything, from connecting you to local accommodations, places of worship and interpretation services, to coordinating follow-up care in your own country. We partner with your family and providers to provide the best possible outcomes, no matter where you call home.
Care That Goes Beyond Medicine
At Nemours, our care for children and families goes well beyond medicine. We offer an array of support services and programs aimed at building strength physically, mentally, emotionally and socially. We help your whole family from the start and stay with you throughout the journey.
Care for International Families
Find out how the Nemours International Medicine Program helps children — no matter where they live — have a healthier and happier future. We’ve cared for hundreds of patients from around the world, in nearly every pediatric specialty. You can count on our expert care and reliable interpreter services. We can assist with housing, transportation and other services too.
Care That Goes Beyond Medicine
Convenient Follow-Up Appointments by Video
We offer follow-up appointments through scheduled, live video visits. You can avoid waiting rooms and save travel time. Ask your doctor if this is an option for your family.
What to Expect: Limb Lengthening & Reconstruction
When you come to Nemours, we want your family to feel comfortable. We’ve created a welcoming environment with all the services and support to make your stay as easy as possible. We tell you everything you need to know so you feel informed and empowered along the way.
If your child is having limb lengthening or limb reconstruction surgery, it helps to know what to expect. Especially if you’re coming from out of town.
General Surgery Timeline
Please note, this is a general overview, and the timelines provided are approximate. Your child’s journey will depend on their specific condition, health status and procedure.
Presurgery Phase
Initial Consultation
- Meet with the surgical team.
- Discuss your child’s condition and treatment options.
- Ask questions and address concerns.
Preoperative Visit
- Complete needed tests and evaluations.
- Finalize the surgical plan.
- Receive surgery preparation instructions.
Surgery & Hospital Stay
The Procedure and Immediate Recovery
- Surgery can last 4-8 hours.
- Inpatient hospital stay for 2-4 days.
Distraction Period (10-12 weeks)
Care at Nemours
- Physical therapy 3-5 per week.
- Office visits every 2 weeks.
- Frame or internal rod adjustment 3-4 times a day.
Consolidation Stage (2-3 months)
Healing Phase
- Return home (if out of town).
- Continue physical therapy 2-3 times a week.
- Video visit/X-ray review with Nemours once a month.
Final Recovery Stage
For External Fixation Devices
- Return to Nemours for device removal (if out of town).
- Limited weight-bearing for 4 weeks.
- No cast required.
For Internal Rods
- Gradual return to full activity.
- Internal rod removed 1-3 years later.
Your Family's Commitment
We understand the toll surgery can have on a child, and the entire family. That’s why we work hard to make it as easy as possible. Overall, the process can take several months and involve:
- 10-15 office visits
- 3 days in the hospital
- 30-60 physical therapy visits
- 2 surgeries (at least)
- 2 visits to Nemours (if traveling from out of town)
- 3-4 monthly video visits
More From Nemours KidsHealth
Nemours KidsHealth offers trusted information and advice written by Nemours experts. Here are a few articles can help you understand your child’s condition, surgery and more.