Children’s Hospital limb-lengthening procedure transforms young lives

WATCH: A new surgeon at BC Children’s Hospital promises to change the lives of many people, with a new technique for lengthening limbs. 

At first glance, the device could be considered a modern day torture device.

It has two large rings, which encircle a child’s limb, connected by six minutely adjustable rods that can be lengthened and shortened to reposition bones.

It’s known as the Taylor Spatial Frame and in the hands of Dr. Tony Cooper, the newest addition to the BC Children’s Hospital orthopedics team; it’s an invaluable tool in correcting limb length and deformities in children and teens.

Children like 12-year-old Michela Ironside, who was diagnosed through a prenatal ultrasound with a rare condition that left her with a bowed tibia, are benefitting from Dr. Cooper’s area of specialization.

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The bowed bone made her left leg five centimetres shorter than her right. The difference in length isn’t noticeable when Ironside runs or walks, but she does become more tired due to one leg compensating for the difference. It would be the equivalent of one leg continually walking up a set of stairs.

“The Taylor Spatial Frame blends orthopedic surgery with biomechanical engineering by a computer program,” said the UK-trained doctor.

“So you can correct any kind of deformity or shortening with very precise and accurate correction. The computer program can allow me to lengthen, shorten, change angulation rotation, all in one go.”

This, Dr. Cooper said, is the main advantage over previous types of surgery that would have used very complex hinges, which you would have to change during the various parts of the procedure.

And the procedure is exact — Dr. Cooper is able to manipulate the bone within one millimetre or one degree.

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“I tell the computer the deformity of the limb and I tell it where I’ve positioned the frame in relation to the bone,” Dr. Cooper said.

“I can also say where there are structures at risk, like nerves, so it will give me a prescription; which I give to the patient and it allows them to very slowly and accurately fix the deformity in their leg.”

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With the new spatial frame, the changes during the lengthening process happen quickly — one millimetre of length is added by the patient a day.

For Ironside, who needs to make up a five centimetre difference, her ‘distraction phase’ will consist of 50 days of lengthening. Every day the Surrey tween turns the six adjustable rods one millimetre and even though the surgery was on Oct. 14, there’s been a noticeable difference.

Ironside said she’s noticed her back and hips feeling less “weird” and is looking forward to going back to dance and learning, in particular, ballet.

“I couldn’t do ballet because you have to be so straight,” she said. “So now I think it will be a lot easier… I’m happy I did this.”

Her mother Joanne said it was like her daughter grew two inches after the surgery.

“It balances her out now,” Joanne said.

“I’m feeling really encouraged. It was so exciting last week to see she increased one centimetre. We were so excited we celebrated by baking a cake.”

After 50 days of growth or ‘distraction’ the next step in the process is the healing phase, where they wait for the newly formed bone to harden. Dr. Cooper said this normally takes the same amount of time as the first phase.

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In Ironside’s case, she’s looking at roughly six months of staying in the spatial frame. After the bone is healed, the frame is taken off her leg and she can start doing normal activities again.

The process may seem long, especially to a child, but Dr. Cooper said the benefits of the new procedure actually include a shorter time in the spatial frame along with less risk of, what Dr. Cooper calls, residual deformities.

“I can fine tune the process as I’m going along to correct any unexpected angulations,” Dr. Cooper said.

“And it means less trips to the operating room, less chance of infection and overall, a much better result.”

Due to the process and success of the procedure, Dr. Cooper’s specialized services are in high demand.

The BCCH have a lengthy wait list and are only able to perform one bone correction surgery a week.

But Dr. Cooper will be one of the many surgeons at BCCH who will benefit from the South Asian community’s A Night of Miracles (ANOM) event. The event is a black tie gala, which is supporting the construction of the ANOM Special Procedures Suites in the new Teck Acute Care Centre at BCCH. Their goal is to raise $3 million for BCCH.

For Dr. Cooper, the new construction will be a welcome addition.

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“The new construction is going to give us a lot more space,” he said. “With technology there’s a lot more equipment and there’s a lot more space needed in the OR. [The space will help the surgical] team and the nurses, which will make things a lot safer for the patients and a less chance of infection.”

Based on the number of children on the wait list, coupled with only having the ability to perform one surgery per week, Dr. Cooper said, when you translate that into the population of B.C., “those are a lot of children that would benefit from this type of surgery.”

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