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This STEAM project covers the course objectives from Unit 4. Specifically:
- Explain how bone development is hormonally regulated
- Know the stages of bone development & repair
According to the US National Library of Medicine, a person’s height is estimated to be determined largely by the person’s genes (MedlinePlus 2024). However, there are many other factors -such as diet- that play important but lesser roles in a person’s height and bone growth.
Despite how tall an individual is being largely out of their control, people still feel insecure or even unhappy about their height. Men in particular are often ridiculed and emasculated if their height is below average. This has led to many finding various ways to improve their stature.
One such method is lower limb-lengthening surgeries. Lower-limb surgeries are an outpatient procedure in which a nail/rod is inserted into either a patient’s femur or tibia.
The first method ever devised, called the Ilizarov method, involved using an external fixator and pins to lengthen the nail while it was still inserted in the bone. This gave rise to various issues, such as pin sight infections, pain, discomfort, and need for clothing adjustments. In recent years, many limb lengthening surgeries have switched to use magnetic intramedullary nails (MILN). These MILN have been able to solve some of the problems seen with the Ilizarov apparatus; however there are still severe complications that can arise from either method (Dubin et al., 2024). These surgeries were originally intended for limb deformity corrections but there has been an increase in the number of people who want it for purely cosmetic purposes (Ramlawi et al., 2025).
For both femur and tibia lengthening, it first starts with an osteotomy. According to Clevelandclinic.org, an osteotomy is “a surgical procedure that involves cutting bone… to reshape or realign your bones.” In this case, the osteotomy is the site of where new bone growth will occur during the lengthening process. For tibia lengthening specifically, an osteotomy is first made in the fibula. In an osteotomy, multiple small pathways are made through the bone with a drill and then it is completed with the use of an osteotome (what is essentially a hammer and chisel). This also allows for bone marrow to exit during the next step. The pathway for the intramedullary nail is then made via reaming. The nail itself is then inserted and held in place with the use of interlocking screws. Typically with one screw proximal and another distal. The entirety of the surgery can take up to 5 hours.
Within a week post-surgery, the patient can begin the lengthening process at home with the use of a magnetic remote control. Patients, if following proper instructions, can see a growth of 25mm or 2.5 centimeters within a month and an average lengthening of 8.7cm after a year (Havitcioglu et al., 2020). After about a year post-surgery, once maximum growth is achieved and if the bone is fully healed, the screws and nails are then removed via another surgery. Both the final surgery and recovery take less time than the initial operation.
As mentioned before, the limb-lengthening procedure itself is not without complications. In fact bone-lengthening surgeries reportedly have a high rate of complications (Havitcioglu et al., 2020). There are complications that can be seen with many different surgeries such as infection and abscesses. Limb-lengthening surgery specific complications can include but are not limited to: hardware failure, new limb deformities, injuries to nerves, malunion/nonunion of the bone, insufficient bone growth/regeneration, and contractures (Ramlawi et al., 2025). In addition, patients are also at risk of complications frequently seen after bone fractures, such as deep vein thrombosis, fat embolisms, and pulmonary embolisms caused by DVT (Paley n.d).
I chose to base my STEAM project poster on vintage advertisements. Specifically Lucky Strike cigarette advertisements from around the 1960’s. In these advertisements, the cigarettes are made to seem like some sort of magical cure that’ll improve a person’s life and attractiveness. I feel like that’s how some unfortunate people may view these surgeries. Some less than honorable clinics or plastic surgeons may prey on people’s insecurities in order to get people to want them.