We believe there is a solution to every skeletal problem.
The HSS Limb Lengthening and Complex Reconstruction Service specializes in limb lengthening and deformity correction for adults and children. Our unique skill with a variety of bone reconstruction techniques enables us to sculpt bone and even create bone where there was none. We provide opportunities for individuals who previously had no treatment alternatives.
This state-of-the-art treatment for leg length discrepancy gradually lengthens the femur, tibia, and humerus with a remote control device and is used when external fixation is not needed.
Pain in the hip, knee, and ankle can often be caused by bowlegs (varus deformity) or knock knees (valgus deformity). This often leads to pain, cosmetic deformity, and premature knee arthritis.
Complex foot and ankle deformity may require gradual correction, treatment for infection and bone loss in the ankle, joint preservation with ankle distraction surgery, and metatarsal foot lengthening.
Problems with bone healing, alignment, or infection can occur after trauma. Nonunion is when the bone does not heal properly and malunion is when the bone becomes deformed or shortens the limb.
Advanced techniques can restore symmetry and function after infection, trauma, or benign tumors damage the shoulder growth plates and cause shortening and deformity of the humerus (upper arm).
The growth potential in children sets them apart. We can reliably equalize limb length, correct deformities, and even increase stature in select conditions, while protecting the growth plates.
We diagnose and treat benign and malignant bone tumors, including the reconstruction of missing bone (bone transport), limb lengthening and deformity correction.
Our Center provides bone transport to replace missing bone and osseointegration limb replacement for patients who have undergone amputation and have difficulty with socket prostheses.
The first to use osseointegration for transtibial amputations in the United States, we offer personalized solutions and the most cutting-edge techniques for those who have had or need lower or upper limb amputation.
A consultation at our Center involves a thorough examination, analysis and discussion before we provide a sophisticated diagnosis and course of treatment. Our synergetic relationship within HSS and other departments provides access to state-of-the-art orthopedic equipment and other bone health experts. From your first appointment to your recovery and rehabilitation, you can expect us to provide in-depth education, personalized recommendations and high-quality care.
Please see our areas of expertise, before and after photos and more information below:
Learn more about the Limb Salvage and Amputation Reconstruction Center
Hear from limb lengthening surgeons
Limb lengthening is possible and has been performed successfully for over 50 years in Kurgan, Russia. Gavriil A. Ilizarov developed the concept in 1951 after seeing many WWII veterans who had leg fractures that had not healed (nonunions).
Ilizarov first developed an external fixation frame that was placed around the leg. Knowing that compression of the fracture would help stimulate bone healing, he built a frame that had this capacity. He instructed a patient to gradually compress the nonunion by turning a rod. However, the patient turned the rod the wrong way and caused distraction (separation) of the fracture. Ilizarov noticed that new bone had formed in the gap between the bone ends. This was the beginning of much research and development that showed that limb lengthening was possible, safe and effective.
Ilizarov and his colleagues performed thousands of limb lengthening procedures in Kurgan, Russia. Russian politics, however, made education and communication with the Western world very difficult. Finally, Italian surgeons started performing and improving the procedure in the early 1980s and a large center soon developed in Lecco, Italy. The first limb lengthening case in the United States was performed in 1988. At first, there was much resistance and skepticism from the US orthopedic community, but limb lengthening has proven to be a very powerful and effective procedure.
Limb lengthening and reconstruction techniques can be used to replace missing bone and lengthen and/or straighten deformed bone segments. The procedures may be performed on both children and adults who have limb length discrepancies due to birth defects, diseases or injuries. The limb lengthening and deformity correction process works on the principle of distraction osteogenesis. This is a revolutionary concept that reverses the long-held belief that bone cannot be regenerated. In this process, a bone that has been cut during surgery can be gradually distracted (pulled apart), leading to new bone formation (osteogenesis) at the site of the lengthening. In this way, bone segments can be lengthened by 15 to 100 percent of their original length. We use a variety of techniques, including the use of monolateral (one-sided) and circular external fixation devices, to correct angular deformities as well as limb length discrepancies.
The regenerated bone is normal and does not wear out. The muscles, nerves and blood vessels grow in response to the slow stretch like they do during a growth spurt or in pregnancy. The actual procedure is minimally invasive and requires only one or two nights in the hospital. Patients aren't in much pain since the distraction is so gradual and patients can continue to walk during the treatment.
Children and adults can be appropriate candidates for the procedure. Children with congenital deformities such as fibular hemimelia, congenital short femur and hemiatrophy will often have unequal leg length and this may be associated with deformity. Many adults have had this condition since childhood and have developed back pain and hip arthritis from the leg length discrepancy. Growth plate fractures and bone infections in children can cause stunting of growth that results in discrepancy.
Following trauma, bones can heal in a shortened and deformed position (malunion). Sometimes the bone can even remain unhealed (nonunion). Limb lengthening procedures address all of these issues. We have been able to successfully correct large deformities and equalize limbs with discrepancies of several inches. A segment of bone can be missing after a bone tumor, bone infection or severe fracture. We can transport new bone to fill in this defect.
Short stature can be very disabling in patients with dwarfism, for example. We can lengthen both legs simultaneously to increase stature. We have been able to lengthen achondroplastic dwarf patients 12 inches in the legs and five inches in the arms. This allows them to function more independently and be able to reach the telephone, toilet and gas pedal, for example.
Young adult patients with leg deformities are at risk for developing arthritis as a result of their malalignment. These same techniques can be used to correct severe deformities safely and avert the need for joint replacement.
For more information read Dr. Rozbruch's article on Limb Lengthening - An Overview.
Bridget Ford, PA-C
Physician Assistant
Bridget Ford, PA-C is a Physician Assistant at the NYLLCRS. She attended Towson University in Baltimore, Maryland where she graduated with a Bachelor’s degree in Biology. On weekends and during the summer, she frequently traveled back home to New Jersey to volunteer as an EMT, which fostered her interest in medicine. She later graduated from Marist Physician Assistant Program with a Masters in Medical Science. Her love of orthopedics was cemented when she did a clinical rotation working with Division 1 and professional team physicians in Denver, Colorado. Bridget joined HSS in 2021 as an inpatient PA, where she quickly gained interest and experience with Limb Lengthening Service and knew that she wanted to further her career in the specialty. In her free time, Bridget is an avid reader and enjoys learning to cook, exploring NYC, and visiting the beach in her hometown in the warmer months.
Maxine Goyette, PA-C
Physician Assistant
Maxine Goyette, PA-C is a Physician Assistant at the NYLLCRS. She attended UC Santa Barbara where she ran Division 1 Cross Country and Track and Field and graduated with a Bachelors in Physiology. Between undergraduate and graduate school she worked as a physical therapy aide and an EMT, shadowed an orthopedic surgeon, and volunteered in the local hospital emergency department. These experiences combined with her background in athletics led Maxine to pursue a career as a PA with a strong interest in orthopedic surgery. She graduated from Weill Cornell Physician Assistant Program with a Masters in Medical Science. As a student at Cornell, she had the opportunity to complete several orthopedic surgery clinical rotations, including one at HSS. After rotating at HSS with an insight into LLCRS, Maxine was convinced this was where she wanted to take her career. Outside of work, Maxine enjoys running, biking, CrossFit, traveling, and spending time with friends and family
Zachary Edelman, PA-C
Physician Assistant
Zachary Edelman, PA-C, is a Physician Assistant for the Limb Lengthening and Complex Reconstruction Service (LLCRS). His love of medicine was fostered at a young age as a volunteer EMT in his hometown in New Jersey. After receiving surgery at Hospital for Special Surgery during his undergraduate studies, he knew he had found his niche in orthopedic surgery. Zachary is a proud graduate of Wagner College in Staten Island, where he completed the dual degree BS/MS five-year PA program. During his course of studies, Zachary especially enjoyed the medical mission trips to Guatemala and Peru where he provided care and training to those in remote villages. Zachary is passionate about helping his patients live their lives to their full potential, and enjoys working together with the talented surgeons on the LLCRS team to make that a reality. In his free time, Zachary enjoys woodworking, hiking, trying new foods and spending time with his family and friends.
Tara Schmidt, PA-C, MS
Tara Schmidt, PA-C, MS has been at HSS since 2012 working on the Spine, Trauma and Foot services and is the current PA Manager of the Combined Specialty Services at HSS. Tara also has eight years of experience in Neurosurgery inpatient/clinic/OR. She recently participated in a submission to the AAPA which led to HSS becoming a recipient of the inaugural Employer of Excellence Award. Tara has an MS in Geophysics and worked for several years as a Licensed Professional Geologist prior to making the transition into medicine. She completed her degree in Physician Assistant Studies in 2010 and she is fluent in Spanish.
Ben Odamtten, PA-C
Physician Assistant
Benjamin Odamtten is a nationally certified physician assistant on the LLCRS. He completed his Bachelor of Science degree in Biology at Utica College of Syracuse University. He then went on to receive his degree in Physician Assistant Studies at Touro College. Prior to joining HSS, Ben worked as an Inpatient Adult Medicine Physician Assistant for six years at Montefiore Medical Center. With a strong medical background and a great passion for the restoration of mobility, Ben could not be happier to be part of the Limb Lengthening Team.
Anna Martinez, PA-C
Anna Martinez Kim has been at HSS since 2015 after graduating from Wagner College where she developed her strong interest in orthopedics. She started her career at HSS covering overnight Team 1 Services. Anna then transitioned to a day time position covering the Trauma, Foot & Ankle, and Limb Lengthening service in 2017.
Erica Lenihan, RN
Erica Lenihan, RN is the Nurse Clinician for the Limb Lengthening and Complex Reconstruction Service (LLCRS) working with Drs. Rozbruch and Fragomen. She began working at HSS upon graduating from Dominican College with her Bachelor of Science Degree in Nursing. She transitioned to the LLCRS after working on the Adult and Pediatric in patient floor at HSS for six years. Her interest and dedication to Limb Lengthening patients gives her the desire to improve and enhance their experiences whenever possible.
Nancy McGuire, LPN
Nancy is the LPN for the NYLLCRS. She facilitates the day to day patient flow, and provides direct patient care in the office. She joined us with twelve years of previous experience in geriatric care, long-term care, sub-acute rehabilitation, and sports medicine. She is currently working on her Bachelor’s degree in Nursing and has strong interests in nutrition and well-being. Her background, expertise, and motivation makes her an integral part of our team.
Omaira Dean
Exec. Asst. & Office Mgr,
Dr. Rozbruch
Omaira Dean is Dr. Rozbruch's Executive Assistant and Office Manager at the Limb Lengthening and Complex Reconstruction Service. Ms. Dean attended NYCT in Brooklyn NY. She began working at HSS in 1998 and joined Dr. Rozbruch at the Limb Lengthening and Complex Reconstruction Service (LLCRS) in 2001. She is an essential member of our team.
Kathiria Torres
Office Mgr,
Dr. Fragomen
Kathiria Rodriguez (Kathy) is the Office Manager for Dr. Fragomen at the Limb Lengthening and Complex Reconstruction Service. She attended St. John’s University with a business major. She joined Dr. Fragomen in the Limb Lengthening and Complex Reconstruction Service (LLCRS) in 2007. She plays a significant role in Dr. Fragomen’s practice.
Rosa Mora
Asst Office Mgr,
Dr. Rozbruch
Rosa Mora is the medical secretary for Dr. Rozbruch’s team at the Limb Lengthening and Complex Reconstruction Service. Rosa attended John Jay College of Criminal Justice with liberal arts major. She then transferred to Hostos Community College to continue her education in liberal arts. She joined LLCRS in July of 2008 and has remained devoted to providing excellent service ever since.
Hennessey Sosa
Medical Secretary, Dr. Fragomen
Hennessy is the Medical Secretary for Dr. Fragomen in the LLCRS. She previously worked for Dr. Rozbruch for almost three years. She attended Dutchess Community College in Poughkeepsie and majored in Human Services; graduating in May of 2015. Hennessy majored in Human Services because she enjoys working with people by being able to help them and fulfill their needs to the best of her abilities. On her free time Hennessy enjoys spending time with family and friends. She also enjoys listening to music and shopping.
Shantel Robertson
Patient Care Coordinator
Shantel Robertson has joined NYLLCRS as a Patient Care Coordinator. As a HSS employee since 2015, her skill sets have contributed to many orthopedic specialists and physical /occupational therapists. Shantel is a universal lover of music and enjoys crime documentary. With a BA in Healthcare Administration, she looks forward to sharing and furthering her education to the public health.
Wilma Cortez
Billing Manager
Wilma Cortez is the Billing Manager for the NY Limb Lengthening & Complex Reconstruction Surgery PLLC. She has a Bachelor’s Degree in Business Administration Summa Cum Laude in Business Management and has worked as a billing professional since 2000. Ms. Cortez takes pride in her job and the service she provides, working with the patients and insurance to get the best possible reimbursement.
Karina Dacto
Assistant Medical Biller
Karina Dacto has joined NYLLCRS in 2022 as Assistant Medical Biller. She has always been passionate about working in the medical field and finally had the ambition to step out of her comfort zone to excel in the industry. In August 2021, Karina attended ABC Training Center and obtained her Certificate of completion in Medical Billing and Coding. Her work consists of following up with insurance claims and communicating with patients to ensure payments are received. Karina considers herself very lucky to work with this extraordinary group of professionals.
Jonathan Torres
File Clerk
Jonathan is the File Clerk for the NYLLCRS. His role over the years has changed and adapted to the progressive technology of computerized medical records. He ensures that our patients’ medical records are complete and up to date. Additionally, Jonathan completes all medical record requests for the service. He is an integral part of our team.
Svetlana Ilizarov, MD
Consultant
Dr. Svetlana Ilizarov was born in Kurgan, Siberia. After graduating from Chelyabinsk Medical School she returned to Kurgan were she was trained by her father Prof. Gavriil A. Ilizarov in Limb Lengthening and Deformity Correction at the Center of Reconstructive Orthopaedics and Trauma (1000 bed Orthopaedic Hospital and Research Institute). She has done clinical research and completed Ph.D. Thesis "Correction of Knee Deformity with Simultaneous Lengthening in Patients with Sequelae of Hematogenic Osteomyelitis of the Distal End of the Femur." She published Surgical Technique Guides on Lower Extremity Lengthening.
In the U.S. she had training in Arthroscopy as international fellow at the Hospital for Joint Diseases and completed Physical Medicine and Rehabilitation Residency program at Mount Sinai Medical Center in New York. She is board certified physiatrist specializing in Rehabilitation of patients after Ilizarov Surgery.
Areas of interest include conservative treatment of other musculoskeletal disorders, Prosthetics/Orthotics, Electrodiagnostic Medicine.
Patients come to HSS to receive the best care available, and it is our mission to ensure each patient we meet gets the best. To that end, we are dedicated to providing services that are within our expertise and referring patients to others master physicians for procedures we do not perform. This ensures the highest standard of patient care.
There are many different kinds of patient conditions that benefit from limb lengthening and complex reconstruction surgery. This includes both upper and lower extremity and both children and adults. The etiology may be after trauma or from birth. The challenge may be limb length discrepancy and/or limb mal-alignment.
Preoperative education about your procedure will aid in your recovery. We want you to understand the details of your procedure and the usual in hospital and post-operative routine. A better understanding of your procedure will empower you to participate in your care and know what to expect during the recovery.
For additional videos, click the menu button 
in the upper right corner of the video player.
Dr. S. Robert Rozbruch, Chief of the Limb Lengthening and Complex Reconstruction Service at HSS, provides at home physical therapy exercises for postoperative patients.
Postoperative Physical Therapy Guide
Covers exercises for the tibia, femur, hinged foot/ankle, and the fixed foot/ankle.
Phase II Strengthening Exercises
Covers exercises for limb lengthening phase II.
Tibial and Femoral Osteotomy
Contains rehabilitation exercises and challenges presented after surgery.
Femur Lengthening with the PRECICE Internal Lengthening Nail
Contains postsurgical rehabilitation exercises.
During the Limb Lengthening and Complex Reconstruction Fellowship, fellows become proficient in the diagnosis, management, decision-making, and surgical techniques associated with limb lengthening and reconstruction. The fellow will gain both clinical and research experience. The Ilizarov method is extensively used in addition to more conventional approaches. This will include preoperative, surgical, and postoperative care. There will also be opportunities for basic and clinical research.
Research is an integral part of the innovation and advancement of our specialty. These publications reflect the breadth of research from the Limb Lengthening and Complex Reconstruction Service at HSS.
Correction of Windswept Rotational Deformity with Fixator Assisted Plating Technique
-S. Robert Rozbruch, MD
Distal Tibial Bone Defect Treated with Bone Transport Using Two Proximal Osteotomy Sites
-Austin T. Fragomen, MD
Tibia Lengthening with PRECICE Internal Lengthening Nail
-S. Robert Rozbruch, MD
Ankle Distraction and Supramalleolar Osteotomy for Arthrosis and Deformity
-Austin T. Fragomen, MD
Femur Lengthening with Precice Internal Lengthening Nail
-S. Robert Rozbruch, MD
Reconstruction of Bone Defects After Malignant Tumor Resection
-Austin T. Fragomen, MD
Proximal Tibial Growth Arrest with Varus, Recurvatum, and Shortening After ACL Reconstruction
-S. Robert Rozbruch, MD
Correction of Bilateral Genu Varum for a High Level Athlete
-Austin T. Fragomen, MD
Correction of Varus Deformity of the Femur and Tibia in Patient with LCL Laxity
-S. Robert Rozbruch, MD
Periarticular Distal Tibial Infected Nonunion, Ankle Salvage With Bone Transport
-S. Robert Rozbruch, MD
Proximal Tibial Bone Defect Treated with Intentional Deformity and Bone Transport
-Austin T. Fragomen, MD
Lengthening of 20cm in the Femur and Tibia to Equalize Leg Lengths in a Growing Child
-S. Robert Rozbruch, MD
Salvage of Metatarsal Lengthening Nonunion with Structural Iliac Crest Autograft
-Austin T. Fragomen, MD
Limb Lengthening and Complex Reconstruction Service
Hospital for Special Surgery
535 East 70th Street
New York, NY 10021
To request an appointment or for general questions, please contact our offices or reach out to a member of our staff directly.
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