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When a person suffers from a limb length discrepancy, bone deformity, or non-union fracture, bone lengthening external fixator (BLEF) can be a viable treatment option. BLEF is a surgical device that attaches to the affected bone, and through mechanical forces, it gradually elongates the bone until the desired length or alignment is achieved. This article aims to provide a comprehensive overview of BLEF, its types, and benefits.
BLEF is an orthopedic surgical device used to lengthen bones. It is a complex device consisting of pins, wires, rods, and screws that are surgically placed through the skin and muscle and attached to the bone. The device exerts mechanical forces on the bone, which stimulates new bone growth and lengthening.
BLEF works by the principle of distraction osteogenesis, which involves applying tension to the bone in a controlled manner. This tension causes micro-fractures in the bone, which triggers the body's natural healing process. New bone tissue forms in the gaps created by the micro-fractures, gradually lengthening the bone.
There are three main types of BLEF:
Circular External Fixator: This type of BLEF consists of two rings that are connected by adjustable struts. Pins are placed through the bone and connected to the rings, which are then adjusted to apply tension to the bone.
Monolateral External Fixator: This type of BLEF consists of a single rod or plate that is attached to the bone using pins or screws. The rod or plate is then adjusted to apply tension to the bone.
Bilateral External Fixator: This type of BLEF consists of two rods or plates that are attached to the bone using pins or screws. The rods or plates are then adjusted to apply tension to the bone.
BLEF offers several benefits compared to traditional bone lengthening methods, such as:
Minimally Invasive: BLEF is a minimally invasive surgical procedure that does not require large incisions, reducing the risk of infection and scarring.
Precise Lengthening: BLEF allows for precise control over the lengthening process, reducing the risk of over-correction or under-correction.
Shorter Healing Time: BLEF stimulates new bone growth, reducing the healing time compared to traditional bone lengthening methods.
Improved Bone Regeneration: BLEF stimulates bone regeneration, which results in a stronger and more durable bone compared to traditional bone lengthening methods.
BLEF is a treatment option for individuals with a limb length discrepancy, bone deformity, or non-union fracture. It is most commonly used in children with congenital limb length discrepancy or adults with acquired limb length discrepancy due to trauma or infection.
Before the surgery, the patient will undergo a series of tests and assessments to determine if they are a suitable candidate for BLEF. This includes a physical examination, X-rays, and MRI or CT scan.
The BLEF surgical procedure involves the following steps:
Anesthesia: The patient is given general anesthesia to ensure they are comfortable and pain-free during the surgery.
Incision: A small incision is made in the skin to access the affected bone.
Placement of the Device: The BLEF device is attached to the bone using pins or screws.
Activation of the Device: The device is activated to apply tension to the bone, and the patient is closely monitored to ensure there are no complications.
Follow-Up Care: The patient will need to undergo regular follow-up appointments with their surgeon to monitor the bone lengthening process and adjust the device as necessary.
After the surgery, the patient will need to take pain medication and follow their surgeon's post-operative care instructions to ensure a smooth recovery. They may need to wear a brace or cast to protect the affected limb and support the healing process. Physical therapy may also be recommended to aid in the rehabilitation process.
As with any surgical procedure, BLEF carries some risks and potential complications. These may include:
Infection: The pins or screws used to attach the device to the bone can become infected, which may require additional surgery to treat.
Nerve Damage: The pins or screws used to attach the device to the bone can damage nearby nerves, leading to pain, numbness, or tingling.
Bone Fracture: The bone may fracture during the lengthening process, requiring additional surgery.
Joint Stiffness: The lengthening process can cause joint stiffness, which may require physical therapy to improve range of motion.
Device Failure: The BLEF device may fail or break, which may require additional surgery to repair or replace the device.
Bone lengthening external fixator is a valuable treatment option for individuals with limb length discrepancy, bone deformity, or non-union fracture. It offers several benefits over traditional bone lengthening methods, including shorter healing time, improved bone regeneration, and precise lengthening. However, it is a complex surgical procedure that carries some risks and potential complications. Patients considering BLEF should consult with their surgeon to determine if it is a suitable treatment option for them.
How long does the bone lengthening process take with a BLEF? The length of the process depends on the amount of lengthening required, but typically takes several months to a year.
Will I need physical therapy after the surgery? Physical therapy may be recommended to aid in the rehabilitation process and improve range of motion.
Is BLEF covered by insurance? BLEF is typically covered by insurance, but coverage may vary depending on the specific insurance plan.
What is the success rate of BLEF surgery? The success rate of BLEF surgery varies depending on the specific case and patient, but it is generally considered to be a safe and effective treatment option.
Can BLEF be used to treat bone deformities in children? Yes, BLEF can be used to treat bone deformities in children with congenital limb length discrepancy.
