Each case is different and deserves attention and a thorough examination

INITIAL EVALUATION

The evaluation, prior to any elongation surgery, must be complete, including the entire examination of the rachis, an evaluation of walking, bone and all soft tissues (muscles, skin, nerves, vessels, etc.). Generally some images are taken (for a comparison before and after lengthening/reconstruction). A psychic evaluation is also necessary to support the patient in the best way at every stage of the process.
Isokinetic muscle evaluation is strongly recommended to better manage preoperative preparation and post-operative rehabilitation. The same machines can also be used to carry out an athletic training in view of the operation. The initial examination allows to make a complete assessment of the organism and to determine the opportunities but also the specific risks of the patient. An accurate measurement will also avoid post-operative complications.
In detail will be analyzed:

• Medical history
• The reasons for the elongation
• The joint and muscular examination
• Evaluation of major functions (vascular, neurological, skin, back, etc.)

An X-ray will be programmed or performed. The visit will allow a meeting, if desired, with other patients in the elongation phase or at the end of the same to better understand the whole.

Preparation for surgery and training

MUSCULAR STRENGTH

After an elongation, the initial muscular strength decreases by 50-60%, and so we find ourselves at 40-50% of the normal strength. Muscle strength weakens and even a year later a deficit of 20% can be found. This means that if the muscle strength is increased in the preoperative period (imagine 50%, that is a post training value of 150%), its postoperative decrease will be the same, but we will find ourselves at 60-75% of the normal force, a very positive factor. A recovery of 100% (of the initial value) will therefore take only a few months.

We recommend an intensive training (muscle program) in the preoperative, to facilitate the total post-operative functional recovery.
This training will increase the mass (increase in strength) and then improve the endurance.

MUSCLE-TENDON RETRACTIONS
A retracted muscle stretching program will be implemented.
The muscles that will need to be well stretched are mainly :

• The tibial ischio
• The anterior rectum of the quadriceps
• The tapered band
• The calves