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Limb Reconstruction

What is Limb Reconstruction?

Limb reconstruction involves the use of an external fixator such as a Taylor spatial frame or the ilizarov apparatus to lengthen bones and/or correct deformity. Internal devices can also be used for lengthening in the older child.

The main reasons for limb reconstruction are:

  1. Congenitally short limbs
  2. Growth plate injuries or disturbances due to trauma or infection. E.g. Meningococcal septicaemia.
  3. Metabolic disorders such as hypophosphataemic rickets
  4. Congenital limb deformities.
  5. Persistent foot deformities such as CTEV.
  6. Trauma

What might physio involve?

If you are considering limb reconstruction surgery you will be seen in clinic by the orthopaedic consultant, orthopaedic nurse specialist and specialist physiotherapist to discuss the options available. The physiotherapist and nurse specialist will go through the principles and practicalities of limb reconstruction including what will happen when you come into hospital, clothing, mobility, getting back to school, physiotherapy on the ward and as an outpatient, dressing changes, how to make adjustments to the frame to lengthen your bone/correct a deformity and how to manage at home whilst the frame is in situ.

The physiotherapist will look at your mobility, joint movement, muscle length and power and, if indicated, give you exercises to work on before your surgery. You may also be measured for a wheelchair which will be ordered before your surgery to help you with longer distances and getting back to school. They will also discuss your home set-up and refer you to an occupational therapist to see if there is any equipment that may help you manage at home whilst the frame is on.

If you live outside of Bristol the physio will also refer you a local physiotherapist to see you after your operation to help you maintain your joint movement, progress your mobility and work on improving your muscle strength.

Physiotherapy on the wards

After your operation the physiotherapist will come and see you on the ward to make sure you are resting with your leg in the best position to prevent any stiffness developing. If you have a frame on your lower leg you will have a special shoe put on your foot and tied up with a band to hold your foot in the best and most comfortable position to prevent your leg muscles getting tight. The physiotherapist will then help you to get out of bed and mobilise using a Zimmer frame or crutches. The physiotherapist or doctor will let you know how much weight you can take through your leg. If you have stairs at home you will practice going up and down the stairs before you are discharged. You will be given exercises on the ward which you will need to continue with at home.

Physiotherapy as an outpatient

Whilst you have the frame on you will need to be seen regularly by a physiotherapist (local to where you live) and complete a daily exercise programme. This is especially important whilst you are doing your adjustments as your muscles have to stretch to keep up with the bone lengthening or deformity correction.  If your muscles become tight, then your joints may become stiff and the adjustments may need to be slowed or stopped for a short period of time.

You will be seen regularly in clinic in Bristol by the consultant, specialist physiotherapist and nurse specialist. If your physiotherapy is not based at Bristol Children's your local physiotherapist will be kept up to date.

You may be seen in the physiotherapy gym or hydrotherapy pool and the length/frequency of your sessions will be adapted according to your progress.

Physiotherapy Contacts

  • Niamh O'Mahony, Rebekah Gausden - 01173428525