Congenital and post traumatic deformity limb reconstruction

The cost of congenital and post-traumatic deformity limb reconstruction with Circle Health Group depends on a variety of factors, including the type of surgery you have and where you have it. There are many different types of limb reconstruction surgery so the price varies from person to person.

Your healthcare team will ensure you know the cost of your treatment at every stage of your journey with them, including information on how and when to pay it. If you would like an estimated quote for limb deformity correction surgery, give us a call and our dedicated advisors can put one together based on your personal circumstances.

If you are paying for your own treatment, our fixed-price packages include the cost of your surgery and all appropriate aftercare appointments. However, any pre-surgery diagnostic tests and your consultant's outpatient appointment fee are charged separately.

Our flexible payment options help you spread the cost of your payment across a time period that suits you. We offer fixed-term monthly payment plans over 10 months to five years with no deposit required. If you decide to pay over 10 months, you will pay interest-free. If you are paying for a longer period, you will pay 14.9% APR.

If you have private health insurance, this type of surgery will usually be covered by your provider. Speak to your insurer directly to find out more information on this.

If you have a limb deformity, whether it’s something you had from birth or developed later in life following an injury, there is a chance that you will have some visible symptoms. These might include:

• Having a limb that isn’t fully formed or missing a component
• Having a leg or arm that is shorter than the other
• Legs or arms that aren’t in proportion to the body

Many people with limb deformities don’t have any visible symptoms – particularly for limb deformities that have developed over time. Some common signs that you have this condition include:

• Pain in your hip, knee, ankle, or back
• Slumped posture
• Unusual walking gait (limping, rotating the leg in an unusual way, walking on your toes, etc.)

At Circle Health Group, we provide limb reconstruction for people with a variety of congenital conditions. There are many limb reconstruction techniques that your surgeon can use, depending on what kind of deformity you are living with.

Fibula hemimelia

Children who are born with a short or missing fibula (one of the two bones in the lower leg).

Congenital short femur

Children who are born with a shortened femur (the thigh bone), causing hip and/or knee instability.

Congenital tibial pseudarthrosis

Known as a 'false joint' whereby the bones in the lower leg are not conjoined properly and don't heal on their own.

Skeletal dysplasia

A series of genetic disorders that affect bones and joints, leading to reduced growth and development.

At Circle Health Group, we provide limb reconstruction for people with a variety of post-traumatic problems and conditions. There are many limb reconstruction techniques that your surgeon can use, depending on what kind of deformity you are living with.

Broken bones

Sometimes, when you experience a fracture or broken bone, it heals at an odd angle, creating what is known as a malunion. They don't necessarily cause you problems right away - you may not notice anything for a while - but eventually malunions can lead to issues on surrounding joints due to them being placed under unnatural levels of pressure by the deformity. A malunion can also mean that your affected limb is shorter than the other, which in turn can cause a limp and, over time, problems with your back due to walking and standing at an angle.

Bone infections

When you have a limb deformity due to a fracture or broken bone healing at an odd angle, it can lead to swelling around tissues in the bone. This often happens in our thigh bone or the bones in our lower legs. Eventually, as the swelling continues, we develop an infection in the affected area (known as osteomyelitis), causing discomfort and limited range of movement.

Blount's disease

A condition generally found in young children that causes the growth plate in the inside of the knee to either slow down or stop making any new bones entirely. At the same time, growth plates near the outside of the knee continue to grow normally, leading to people with the condition to have a bowlegged appearance (when the legs curve outward).

Rickets

The softening and thinning of the bones due to an inability to absorb calcium, leading to reduced bone growth and shorter appearance. This condition can also be present from birth.

Enchondromatosis

A title given to a series of conditions that can influence the growth at the ends of bones (Ollier's disease, dyschondroplasia, etc.), generally experienced during childhood on one or both sides of the same bone.

To start with, your consultant will ask questions about your medical history, taking care to get a full picture of how long you've lived with your deformity and what treatment (if any) you've had in the past. You will then have a physical examination - one designed to test your range of movement, posture when walking and/or standing, and whether you experience pain at any time. This examination helps us understand your exact deformity and what kind of treatment would be most effective.

It may be that we need to have more than one appointment before deciding whether surgery is the way to go, or what kind of surgery you require. To help your consultant reach a decision that is right for you, they might conduct a CT scan – an image test that uses X-rays and a computer to give a detailed scan of the body, clearly showing the length and position of the bones and muscles in the area in question.

Having completed their examination and scans, your consultant will explain the treatment plan they would recommend for you and answer any questions you might have. It is possible that they will run further tests, such as checking for your vitamin D levels and whether you have any infections, as this may negatively influence the outcome of the surgery.

There are several ways you can prepare for congenital and post-traumatic deformity limb reconstruction, including:

Plan for a hospital stay

If you are having private limb reconstruction surgery, you will need to plan for a hospital stay of two to four days, depending on the exact procedure that has been chosen for you. Given that surgery will potentially involve fitting an external frame over the affected limb, please bring loose comfortable clothing that will fit over the frame. If needed, we can provide some clothing for you.

Medication

If you are taking aspirin, anti-inflammatory medications, warfarin, or any other medications that are 'blood thinners' and increase the risk of bleeding, your consultant will advise you to stop taking them one week before your surgery date, as this helps to prevent any unwanted bleeding during and/or after the limb reconstruction surgery.

Eating and drinking

Take care to eat a healthy balanced diet in the lead up to your operation, and avoid drinking alcohol within 48 hours of the procedure. You will also have to refrain from eating or drinking anything past midnight on the day of the surgery.

Stop smoking

If you are a smoker, you will need to stop before the surgery. This is because smoking can cause complications with your breathing under anaesthesia and during recovery, along with posing risks to how well you recover overall. This is especially the case if you keep smoking after the procedure. For more information about this, please chat to your consultant.

Stock up on supplies

When you get home after limb reconstruction surgery, your mobility will be limited, and chances are you will feel quite tired and need to take naps every now and again. To help with your recovery, be careful to not push yourself too hard and rest as much as possible. You won't be able to make quick trips to the shop, so make sure you stock up on everything you need before the surgery and put it near where you'll be resting. Should you need any additional supplies, ask a member of your support network to grab them for you if possible.

There are different kinds of congenital and post-traumatic deformity limb reconstruction surgery, depending on your particular issue. Treatment is often ongoing, sometimes requiring more than one operation. You may also require some kind of plastic surgery. The surgery you receive will depend on your age, the specific limb deformity you have, and what needs to happen in order to fix the issue. This could involve:

• Lengthening tendons that are too short
• Releasing joints that have become too tight
• Straightening bones that have become bent and holding them tightly in place so they heal in the correct position
• Growing the bone straight again
• Growing a new bone that was missing
• Lengthening bones that are too short

Your consultant will give you a full explanation of the treatment you need and how it will work, along with detailed information about recovery. The two most common forms of congenital and post-traumatic deformity limb reconstruction are limb lengthening and deformity correction - which are often carried out at the same time and always done under general anaesthetic, which means you'll be asleep the whole time and won't feel any pain at all.

Limb lengthening

Limb lengthening surgery involves two separate phases: the distraction phase and the consolidation phase.

During the distraction phase, your surgeon will make an incision at the top of your affected leg or arm and cut the bone to create two separate bone segments. If needed, they may complete other small procedures to prepare your muscles and nerves for the lengthening process. This separation is done using either an internal or external fixator. The former is a telescopic rod, known as a precise nail, that is placed inside the centre of the bone and gradually lengthened using an external remote control until the desired length is reached.

An external fixator, on the other hand, is a frame that goes around your limb, such as the Ilizarov device, which consists of rings connected by straight rods that attach to the bone using wires.  They are finely adjusted over time to change the length of your bone.

Once this surgery has been completed, the bones are allowed to rest for five to seven days - known as the latency period. After this period, the fixator will be adjusted so that it pulls apart the two bone segments, allowing for a new bone to form in the space between them (the regenerate bone), which increases the overall length of the bone.

During the consolidation phase, which lasts around four to five months, the regenerate bone slowly hardens. It will take around two months to achieve the desired length, followed by another two or three months to properly solidify. The bone can only be said to have fully healed once it's hardened. This timeframe varies from person to person, and your consultant will be there to monitor and support your recovery every step of the way.

Deformity correction

Often carried out at the same time as limb lengthening, this procedure involves your surgeon making an incision at the top of your limb and using guide wires to isolate the deformed part of the bone that needs to be removed. A special surgical instrument is used to remove this part of your bone. Having done this, your surgeon will close the gap in your bone by bringing the bone edges together. Depending on your situation, this might involve using pins, screws, staples, plates, or rods to hold the bone in place and keep it in a correct position.

After realigning the bone and joints, making sure they are in a correct position, your surgeon will clean and close the area, after which you will be transferred to the post-operative area.

Your full recovery from congenital and post-traumatic deformity limb reconstruction surgery will take around six months, but this varies depending on a variety of factors, including your age and general health and fitness levels.

Recovering in hospital

You will need to stay in hospital for a few days after your limb reconstruction surgery, usually between three and seven days, as this allows us to monitor how your limb has responded to the surgery and provide you with adequate pain relief during this time.

One to three days after surgery

When you wake up from surgery, your head will probably feel rather foggy, and you'll also be quite tired. You might experience some pain, but our team of nurses will ensure you are provided with enough pain relief throughout the day to feel comfortable. During this early stage, you will be encouraged to rest in bed with your leg elevated.

One to four weeks after surgery

You will usually be discharged from hospital after one week.

Before you are discharged, you will have met with a physiotherapist, who will have made a custom recovery programme to help you recover as quickly as possible. Some of our hospitals offer advanced rehabilitation programmes with our dedicated physiotherapy teams. If this is something you'd be interested in, speak to your consultant before surgery. We will also offer any occupational therapy support wherever needed, such as advice around getting dressed, cleaning pin sites, and ensuring you have assistance with activities at home if required.

After a week, you will be able to take gentle walks using crutches, but be sure to avoid putting full weight on the affected area. Keep the wound elevated above chest level as much as you can.

The wound takes around two weeks to heal, so you will need to actively make sure the wound remains clean and dry around where the pins have been inserted to prevent a build-up of scarring and potential infection. You can take showers during this time, but avoid soaking in a bath.

Two to six weeks after surgery

At around the two-week stage, with the wound healed, you will be able to enter the next phase of your physiotherapy rehabilitation programme. You will not be able to drive during this time, but you can return to work after around three weeks if your job just involves sitting down at a computer and/or phone. Everyone differs in this respect, so speak with your consultant about this.

Back in the hospital, your physiotherapist would have set out a full detailed recovery plan for you - exercises designed to gently bring you back to a full range of movement and flexibility, with the intensity going up over time as appropriate. The most important element of this period after surgery is staying loyal to this programme, along with avoiding nicotine or anti-inflammatories due to how they slow the healing process.

During recovery, you will have check-up appointments to ensure things are running smoothly. If there is any follow-up surgery required, such as the removal of pins, we will schedule this for you. Normally, full recovery takes around six months, but this really depends on the individual.

Despite being quite a serious and moderately invasive surgery, congenital and post-traumatic deformity limb reconstruction is a safe procedure. That said, there are always some potential risks and complications with any operation.

General complications of any operation:

• Pain
• Bleeding
• Infection of the surgical incision
• Unsightly scarring
• Blood clots
• Difficulty urinating
• Chest infection
• Heart attack or stroke

Specific complications of congenital and post-traumatic deformity limb reconstruction

• Pin site infection
• Increased pain around the pin site
• Joint stiffness and/or instability (properly following your physiotherapy programme usually stops this from happening)
• Nerve and blood vessel injury
• Acute compartment syndrome (when swelling or bleeding causes increased pressure within muscle compartments)
• Pressure ulcers
• Failure of lengthening/straightening the bone
• Problems with your fixator
• Refracture of the bone

Your consultant will explain everything to you and answer any questions before the surgery, giving you all the time and information that you need to make the right decision for yourself.

When you choose to go private with Circle Health Group, you can expect:

• Flexible appointment times and locations to fit around your routine
• Ability to choose which hospital and consultant suit your needs
• Personalised, consultant-led treatment plans adapted to your personal needs
• Comfortable and safe private facilities maintained by expert multidisciplinary teams
• Private cosy ensuite rooms as standards and delicious healthy meals
• Affordable, fixed-price packages with aftercare included
• Flexible payment options to help you spread the cost of your care

If you would like to learn more about this procedure, book your appointment online today or call a member of our team directly on 0141 300 5009.

Content reviewed by Circle in-house team in November 2022. Next review due November 2025.

Limb Reconstruction, The Royal Children’s Hospital Melbourne
Blount’s Disease, John Hopkins 
Limb Lengthening: The Process, Lifebridge Health