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World J Orthop. May 18, 2026; 17(5): 114902
Published online May 18, 2026. doi: 10.5312/wjo.v17.i5.114902
Published online May 18, 2026. doi: 10.5312/wjo.v17.i5.114902
Limb lengthening for limb length discrepancy: Overview, complications, and new treatment algorithm
Jana A Kotaich, Giovanni D Yanni, Elissa E El Toum, Ali Ismail, Faculty of Medical Sciences, Lebanese University, Hadath 00000, Lebanon
Jana A Kotaich, Giovanni D Yanni, Department of Orthopedic Surgery, MEDICA Research Investigation, Hadath 00000, Lebanon
Elissa E El Toum, Ali Ismail, Department of Neurology, Medica Research Investigation, Hadath 00000, Lebanon
Elissa E El Toum, Department of Neurology, Saint Georges University of Beirut, Beirut 165146, Lebanon
Mohammad Daher, Amer Sebaaly, Faculty of Medicine, Saint Joseph University, Beirut 166830, Lebanon
Mohammad Daher, Amer Sebaaly, Department of Orthopedic, Hotel Dieu de France, Beirut 166830, Lebanon
Author contributions: Kotaich JA was responsible for conceptualization, methodology, investigation, writing original draft, review and editing; Yanni GD, El Toum EE, and Ismail A were responsible for methodology, investigation, and writing original draft; Ismail A was responsible for preparation of hand-drawn figures; Daher M was responsible for resources and critical review of the manuscript; Sebaaly A was responsible for supervision, guidance on study design and interpretation, writing review and editing; all authors have read and approved the final manuscript.
AI contribution statement: ChatGPT and Grammarly were used only for grammar checking and language polishing after the manuscript had been originally written by the authors. The authors confirm that no section of the manuscript, including the abstract, introduction, materials and methods, results, discussion, or conclusion, was generated by AI. AI tools were not involved in the study design, data analysis, interpretation of results, or scientific conclusions. No AI-generated images were used; all figures were hand-drawn or prepared by the authors using Microsoft PowerPoint.
Conflict-of-interest statement: All authors declare no conflict of interest in publishing the manuscript.
Corresponding author: Jana A Kotaich, MD, Faculty of Medical Sciences, Lebanese University, Inside Uni Lb, Baabda, Mount Lebanon Governorate, Hadath 00000, Lebanon.
Received: October 10, 2025
Revised: November 25, 2025
Accepted: January 26, 2026
Published online: May 18, 2026
Processing time: 229 Days and 20.9 Hours
Revised: November 25, 2025
Accepted: January 26, 2026
Published online: May 18, 2026
Processing time: 229 Days and 20.9 Hours
Core Tip
Core Tip: Limb lengthening has become an essential surgical option for patients with limb length discrepancy, yet its complexity and associated complications demand structured guidance. This mini-review synthesizes current evidence on external and internal fixation methods and highlights both physical and psychological outcomes. Importantly, we introduce a new treatment algorithm for limb length discrepancy that integrates patient-specific factors, complication profiles, and multidisciplinary perspectives. By providing a practical framework, this algorithm aims to support surgeons in optimizing decision-making and improving both functional outcomes and quality of life in patients undergoing limb lengthening.