Is limb lengthening surgery safe?

Leg extension in the operating room

Breaking legs for the trend of beauty A frightening new trend is coming from the Russian Kurgan: Young women have their bones broken and lengthened there, because long legs are known to be sexy. MEDIZIN popular describes the dangers of this procedure and investigates the reasons for which and with which methods legs are lengthened in Austria. By Mag. Sabine Stehrer

Whether Claudia Schiffer, Heidi Klum or Naomi Campbell: Actually, you only need to look at top models like these three to see one thing: Long legs are considered beautiful and look sexy. But there is even scientific evidence of this in the form of a study recently carried out at the University of Wroclaw in Poland. There, 218 test persons were presented with pictures of women and men who were the same size but had legs of different lengths. The result: those who had legs that were five percent longer than the average legs were perceived as particularly attractive. The explanation of study leader Boguslaw Pawlowski: Long legs signal to the primitive man in us that one can go further with it, flee faster and therefore survive better and healthier. And these are really big advantages when it comes to choosing a partner for species conservation.

More and more young women in the Far East and Asia rely on this basic instinct. In order to arrive better in our society, specifically, to have more happiness in love and better opportunities at work, 200 young Russian women have their legs extended every year in a clinic in Kurgan in Siberia. The lower leg bones are cut through and pulled apart millimeter by millimeter in a month-long procedure. Bone mass forms in the gap, so the lower leg becomes longer and longer. With up to 15 centimeters more leg, women finally return home. “Legs from Kurgan” have already become a fixture, and not just in Russia. Kurgan-style leg extensions are also enjoying increasing popularity in China and Japan.

NOT FOR BEAUTY'S SAKE
Leg extensions are also carried out in Austria, with 80 per year by far the most, namely 90 percent, at the Speising Orthopedic Hospital in Vienna. Although there are always corresponding inquiries from women who want longer legs because they think they will increase their attractiveness, but purely for the sake of beauty there are no operations in Speising, says senior physician Dr. Rudolf Ganger. Even when it comes to helping short stature grow taller by lengthening their legs, the orthopedic specialist and his colleagues rarely take action. Once, says Ganger, they made a woman eight centimeters taller. “But it was so small that she even had difficulty using a public toilet.” Another time a leg extension was supposed to relieve a little man of his depression: He had submitted a psychological report that showed that the leg extension was his would help.
Mainly in Speising, but also at the Vienna General Hospital as well as in Graz and Innsbruck, where leg extensions are also carried out, candidates for the procedure are those who have legs of different lengths due to birth defects, illnesses or accidents. But here, too, there is a limitation: surgery is only performed if there is a difference of two and a half centimeters. If the difference between the right and left leg is smaller, it can be compensated for by wearing special shoes, says Ganger.

BONE WILL BE CUTTED
There are good reasons for the strict selection in Speising, as well as the fact that the Ministry of Health in Beijing now wants to take action against doctors, lengthening the legs only for the purpose of increasing attractiveness. The interventions are not without. They are tedious and painful for those affected, lengthy and not risk-free.
Two methods are used to operate. The first and older was developed in the Soviet times by the Russian orthopedic surgeon Gavril Ilisarow in Kurgan to eliminate birth defects and to help war wounded. It is still used by many patients today. Here, the thigh or lower leg bone is severed, then a metal construction, the ring fixator, is mounted around the leg. In Speising, a further development is used, the so-called Taylor spatial frame.

ONE MILLIMETER MORE PER DAY
Six rods are attached to this construction, which protrude into the bone and are fixed there with drill wires and screws. Lengthening can begin one week after the bone has been cut. Ganger: "The lengthening works by the patient adjusting the rods himself." The bone is stretched apart, and bone mass grows back in the gap. One millimeter in length can be gained per day, for five centimeters you need 150 to 200 days, including the time it takes for the bone to solidify. The lengthening of the bone itself is not painful, says expert Ganger. "The holes in the skin through which the rods lead into the bones and the constant tension on the leg often hurt." This occurs because apart from the bones, the skin, muscles, tendons and nerves also have to grow with the leg. In order to be able to withstand the procedure better and to keep the leg flexible, the patients receive physiotherapy during the leg lengthening. After the fixator has been removed, it will take a while before the leg can be loaded normally again. Ganger: "All in all, you can expect to spend a year on leg lengthening."

MARINAL NAIL WITH MOTOR
The procedure takes up to a year even if the leg is lengthened using the newer method with the so-called intramedullary nail. With this method, which was developed in Germany, you can do without a fixator or other externally mounted construction, and the wound pain at the holes through the skin is eliminated. Ganger: “The intramedullary nail is placed in the bone, there is a motor in the nail and a receiver under the skin. A computer with a transmitter gives the command at regular intervals to adjust the nail so that the bone is continuously pulled apart. ”The rest works like method number one, bone mass grows in the gap, the leg gradually becomes longer, but only by a maximum of one millimeter per day. A total of eight centimeters can be extended.

THE POSSIBLE HAZARDS
The main risk that the operation entails is (with the externally mounted fixator) inflammation from the drill wires and screws. However, the procedure can also result in misalignments of the bones and restricted mobility in the joints. Despite these risks, Ganger would definitely recommend leg lengthening to people with a leg length difference of five centimeters or more. "Because if the difference is so great, shoes can no longer compensate for it, and the entire musculoskeletal system is so asymmetrically stressed that massive and painful consequential damage such as osteoarthritis in the joints is likely."
By the way, it's never too late for a leg lengthening: Ganger and his colleagues have already successfully treated a 72-year-old who had a shorter leg with a misalignment after a motorcycle accident. However, the lower age limit is not open. Congenital defects cannot be operated on until the person concerned is around three years old. Sometimes you have to wait for the end of growth.