Physical Therapy During Limb Lengthening and Deformity Correction: Principles and Techniques

Physical therapy for children undergoing limb lengthening and correction of their lower limb deformities is a specialized area requiring focused and customized care for optimal outcomes and long-term functional results that should last a lifetime. For example, it is critical that a child that undergoes limb lengthening at age 10 not get early arthritis or other sequellae of the hip, knee, or ankle as an young adult. The successful outcomes of the limb lengthening should not be graded based on the amount of length and correction achieved, but on long-term functional outcomes. Without appropriately supervised physical therapy, patients may be at an increased risk for permanent complications such as contractures, nerve palsy, joint subluxation, dislocation, and painful early onset of arthosis. A patient undergoing lengthening and correction requires supportive caretakers and compliance with physical therapy sessions (typically 3–5 days per week) so that early detection and appropriate treatment of these complications is feasible. An experienced physical therapist, working alongside the healthcare team, can allow the patient to return to functional activities after lengthening and deformity correction are completed. A sustained and customized physical therapy program, including a diligent home exercise program, appropriate use of braces and other therapeutic modalities, helps optimize long-term clinical outcomes.