The effect of this drug wears off between 3 and 6 months after injection. Patients are examined at follow-up visits every 2 weeks during the lengthening phase. On these visits, we perform nerve testing, examine the pin sites, and obtain x-rays. Problems are identified and treated, and prescriptions for medication for pain and for antibiotics are written. We prefer to use motors for LFS based on evidence that they are gentler to the muscles and nerves.
Motors are more expensive.
Lengthening does not begin until 1 week after surgery. Because the fixators are on both legs, weight bearing is not permitted except for transfers from bed to chair or toilet and vice versa. This means 2 to 3 months in a wheelchair during the lengthening phase. At the end of the lengthening, a second operation is performed to insert screws into the metal rods that are inside the bones and the external fixators are removed. Because the rods fix only the tibiae, an additional screw is needed for each fibula to protect the fibula from shifting from the ankle.