There were several options each with their own advantages and disadvantages.
Quadrilateral
The main goal was to achieve maximum limb lengthening. The most effective way to do this was through two separate surgeries. The reputation of quadrilateral limb lengthening being challenging and the high number of unsuccessful cases discouraged me from seriously considering this approach. I aimed to gain a height increase of six inches if feasible.
Sequential Femur and Later Tibia Lengthening
Considered the most ideal method as it allows for the safest way to achieve maximum length. This staged approach also offers a straightforward exit strategy in case I am satisfied with my height after the initial surgery. Starting with tibia lengthening would likely result in a lesser height gain. Additionally, a negative experience during tibia lengthening may deter me from undergoing a second procedure. Solely focusing on tibia lengthening also heightens the risk of potential knee or joint complications in the future.
Simultaneous Bowleg Correction and Tibia Lengthening
Although feasible to perform concurrently, combining these procedures complicates the process and may lead to unpredictable outcomes. It is deemed more favorable to separate them for better control of results.
Initial Femur Lengthening and Bowleg Correction – Subsequently Tibia Lengthening
This was the chosen option as it met my objectives of maximizing height gain through a single lengthening procedure. It also facilitated the correction of bowleg and knee alignment issues simultaneously. Otherwise, I would have to wait 6-12 months before addressing these concerns separately. Given a potential unfavorable experience during the initial surgery, I was reluctant to undergo another procedure. Moreover, a beneficial aspect of this strategy was that insurance coverage could apply to the medically necessary portion of the surgery.
