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Medicine’s answer to dwarfism

Not many are aware that the Goa Medical College, Bambolim is equipped to conduct a minor surgery called the Ilizarov technique – usually used to fill the fractured gap in the bone – now also used to increase height of a person. NT KURIOCITY speaks to professor and head of department of orthopaedic surgery and medical superintendent at Goa Medical College, Bambolim, S M Bandekar to get more details

RAMANDEEP KAUR | NT KURIOCITY

Though height is not seen as a hindrance to achieve anything in life, but in cases wherein one aspires to get into some profession that has a height requirement it surely can be a problem and it is then the Russian technique called the Ilizarov technique comes into the picture. The Goa Medical College has started using Ilizarov technique for height increase about two years ago and has so far carried out three surgeries successfully.

Elaborating upon the technique used, professor and head of department of orthopaedic surgery and medical superintendent at Goa Medical College, Bambolim, S M Bandekar says: “The Russian technique called Ilizarov technique is used when someone meets with a high velocity fracture; or a part of the bone is lost on the road and you cannot retrieve that bone. So the remaining bone of that gap is filled up with the new bone that is generated by the body using this technique. Earlier we used this technique only for fractures with bone defect, but now it can also be used for patients who have stunted growth or height problems.”

The procedure for the lengthening is done surgically under anaesthesia. The bone to be lengthened is first cracked through a small incision made in the limb. The limb is then stabilised using either an external or internal fixation device. Most patients stay in the hospital for a day or two after surgery with physical therapy starting the day after surgery. Maintaining joint mobility is an essential requirement during the distraction and lengthening of the bone that usually starts five or ten days after surgery. During the distraction phase, the cut in the bone is slowly pulled apart with daily adjustments being made to the fixator or rings. As the space between the bones increases, the body will produce new bone in the gap until the required amount of bone is generated.

During the lengthening phase of treatment, patients are X-rayed and examined periodically to evaluate bone growth, nerve and muscle function and to also have the pin sites examined for any infection. After the desired length of bone has grown and the limb has been straightened, adjustments to the fixator are stopped. During this phase, the fixator is not removed while the new bone hardens and matures. Once the new bone is completely healed, as confirmed with X-rays, the fixation device is removed and the procedure distraction procedure is discontinued. This is done as a same day procedure under general anaesthesia. To protect the bone a cast or brace is placed on the limb after the fixator has been removed, it will have to be worn for a few weeks.

Bandekar adds that the principle is the same as normal growth. The bone regenerates at the rate of 1mm per day and this is called osteogenesis. Thus every day you increase in height by 1mm, for example: if someone wants to increase their height by two inches (that is 50 mm), this will happen at the rate of 1 mm per day because the whole apparatus is programmed to increase the space between the cut bone. “Once you have that height, there is something called as holding time, the holding time is about another 50 days, so in 100 days you can achieve two inches which is a quite a big thing,” says Bandekar who has been an orthopaedic surgeon for almost 25 years.

He further explains that this surgery is performed on people who aspire to some professions that require good height; but there are other cases like that of some diseases like dysplasia, dwarfism that lead to stunted growth, and this technique comes into play to increase the height or increase the length of the limbs. It can be used for bones in the forearms, arms, legs to get a desired length, but the doctors do not encourage patients to increase their height when they are of average height, Bandekar says: “If the patient is absolutely normal I would considerer the increase in height to be a bit of luxury, but when you do it for a fractured bone with a gap, it is the need of the hour. We started doing the lengthening procedure two years ago and we have very successful cases. We do not encourage patients to increase their height to become tall; we only do it for those who are in need of it. We have already done for three surgeries and they have been successful.”

The surgery is done free of cost, but sometimes when the hospital does not have the Ilizarov ring patients are told to buy the rings; each costing `3000 and a maximum of three rings are used on each limb. Bandekar says: “We have enough rings with us now, so we provide them for free of cost. A very small scar is left for the lengthening process and these rings do not leave any marks on the body as they are fixed externally.” Elaborating more about Ilizarov ring, he informs that there are different sizes of rings that are put for lengthening the bone and are removed after achieving the required length.

Bandekar also assures that there are no side effects of the technique, but since it is a surgical procedure, one may feel pain for two or three days. Bandekar concludes by saying that for females up to the age of 17, height can be increased by using medication as there are some hormones which can increase height. Some stretching exercises and a good protein-rich diet can also aid in the second growth spurt that begins sometime between ages 9-15 and is usually completed by age 17.  “For a mature person beyond this age, it is difficult to increase height, if the person wishes to increase their height, and that is when the Ilizarov technique comes into play. This technique is meant for a matured skeleton and can do be done at any age,” concludes Bandekar.

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