Screaming woke Lanz Ellingsworth. The piercing cries were loud, they were shrill — and they were coming from his daughter's bedroom.

At 8:30 p.m., Ellingsworth and his wife had tucked their youngest, Lindsay, in for the night. They read her a bedtime story, kissed her on both cheeks and crept out of the room. Six hours later, their little girl was a mass of quivering agony.

In the middle of the night Lindsay had shifted slightly in her sleep. The abnormally brittle femur in her left leg splintered into multiple pieces. She woke from her dreams and plunged into a living nightmare.

"When I woke up that night, what I kept repeating was that 'somebody hit me with a sledgehammer,' Lindsay says. "That's how it felt. Somebody literally smashed my leg with something. And I just screamed."

Lindsay, a tiny, freckled eight-year-old, was used to pain. She was born with a congenital limb deformity called "underdeveloped femur condition," in which one leg is shorter than the other by more than two centimeters. Up to 100,000 people are diagnosed with limb-length disorders in the U.S. each year, according to Bart Balkman, vice president of Ellipse Technologies, an Irvine, Calif.–based orthopedics company.

Left untreated, the condition can result in chronic pain, loss of mobility, degenerative arthritis and debilitating scoliosis, an abnormal and painful curvature of the spine that typically progresses throughout one's lifetime. At birth or shortly thereafter parents whose children have a severe discrepancy (estimates range from a two- to three-centimeter or more differential) must make a decision—amputate the shorter limb or commit to a lengthening regimen to equalize them.

"Can you ever imagine having a child and loving that child and being told that part of your child's leg had to be amputated?" says David Hootnick an orthopedic surgeon in Onondaga County, N.Y., who studies congenital abnormalities. "Can you imagine the emotional stress you'd have to go through?"

Limb-lengthening technology has progressed significantly from the early 1950s when a handful of doctors first began the practice. Gavriil Ilizarov invented the external fixator in Russia, a device he modeled after a horse harness. Now, about 100 surgeons in the U.S. perform limb-lengthening procedures, and a new internal approach offers patients expanded mobility and promises fewer complications. The device, called "Precice," received U.S. Food and Drug Administration approval for consumer use but is still relatively unknown within the greater medical community.

[View a slideshow of the Precice technology.]

By far the most common procedure for children with leg discrepancies—and the one used in Lindsay's surgery—is an external "fixator." Surgeons break a patient's bone in half and pull it apart, allowing the body's natural healing capabilities to fill in the gap with new bone, thereby lengthening the limb.

John Blanco, a specialist in pediatric orthopedics and scoliosis at the Hospital for Special Surgery in New York City, has been performing the operation for years. With the patient under a general anesthetic, Blanco drills screws into the top and the bottom of the afflicted bone. The screws are fastened into a metal frame that will stabilize the leg during and subsequent to the procedure. After cutting a small incision in the leg, Blanco takes a hammer and breaks the bone in two. It's a dull sound, he says, like hitting wood—more of a thwack than a snap. The finished product resembles an Erector Set construction covering the leg.

10 Comments

1. 1. podboq 04:54 PM 12/27/12

   New tech?? If 20 years old or older is 'new' I guess the article is correct.
   

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2. 2. podboq 04:58 PM 12/27/12

   Oh ok, a magnetically driven internal fixator, I finished reading... neat!

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3. 3. tempedan 07:13 PM 12/28/12

   Imagine her strength, resolve and toughness! One day this young lady will run a company or be an astronaut or be President of the United States or inventor or teacher or have some other amazing role.

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4. 4. Carlyle 05:48 AM 12/29/12

   discrete pieces of bone are pulled apart to lengthen legs an average of 1.25 centimeters per day. The body regenerates bone, filling the gap in a matter of hours.
   Does the author realise that is half an inch per day?
   
   Legs can only stretch about 12.7 centimeters at a time so patients must come in for multiple operations.
   Does the author realise that is over 5 inches?
   
   Do these things get edited? This is supposed to be a science magazine.
   
   Great education system you have in the USA. Not understanding the difference between metric & imperial measures led to a Mars spacecraft worth billions being lost a few years ago & no doubt many deaths each year through wrong prescriptions & the like.
   

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5. 5. bucketofsquid in reply to Carlyle 12:10 PM 1/3/13

   My independent research on the lengthening process shows that it yields around a millimeter a day so I'm pretty sure the lengths described are incorrect. Carlyle is correct. This is what happens when we stick with an out dated system of measurements.

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6. 6. lindsayellingsworth 04:05 PM 1/3/13

   Obviously you did t research it enough bc Im 100% sure that my X-rays don't lie neither do my Drs. Out of 10 inches of being short, I gained 8 1/2 inches with two lengthenings that were both stretched over an 8month period within 3 yrs of each other.

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7. 7. mylady_13601 04:13 PM 1/3/13

   I know this lady personally and she is the most amazing girl that you will ever meet. She has the biggest heart and the most loyalty that you could ever ask in a person. She never lets anything get her down. She keeps fighting till she wins. I am very proud to say that I know her and she is a friend of mine. You couldnt ask for a better person.

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8. 8. Elviva21 11:33 AM 1/20/13

   Lindsay, please can I get to know more about your procedure. I am 21 this year just under 5ft 7 (173 cm). I am thinking of a height surgery for couple of years now but will only be looking for 3-4 inches max. Is there any recommendation you can give?

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9. 9. rellisacct in reply to Carlyle 11:07 AM 1/24/13

   Carlyle, maybe we should go the Eastern European model or maybe the Zambian model of living. Before you blubber away about how bad the American way of doings things is, lets first remember that 90% of the world's innovation of the past 100 years has come from our "backwards" ways of doing things. I do realize that there will always be people who hate America out of jealousy and I can't blame you for that. If I didn't live in America, I'd be jealous and hate America too. Most of the rest of the world tries to implement democratic constitutions and the American way of life for a reason and there's a reason we have a massive IMMIGRATION problem, not EMIGRATION.

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10. 10. lindsayellingsworth in reply to Elviva21 11:29 PM 1/31/13

    I have a Facebook, you can certainly contact me through there.

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