Limb Lengthening and Complex Reconstruction Center

The Limb Lengthening and Complex Reconstruction Center is a specialized center with the training and experience to give children with limb length inequality, deformities and associated conditions of the upper and lower extremities the comprehensive care they need—irrespective of underlying complexity. We provide a multidisciplinary team of specialists with the clinical expertise to use advanced reconstruction techniques to help each child reach their highest level of function, comfort and mobility.

Limb Lengthening and Complex Reconstruction Center

Our goal is to help your child have the best function possible and be as active as they can be. We offer a full range of treatment options, both with and without surgery.

Advanced Reconstruction Techniques & Multidisciplinary Collaboration

Our team includes pediatric orthopaedic surgeons with special expertise in limb lengthening, deformity correction and complex limb reconstruction. Special expertise includes:

  • Orthopaedic Oncology
  • Orthopaedic Trauma
  • Rehabilitation Medicine
Because we can offer the resources of a large pediatric research hospital, our patients have access to our experts in:
  • Plastic Surgery
  • Hand Surgery and Microsurgery
  • Prosthetics and Orthotics
  • Physical Therapy
  • Occupational Therapy
  • Sports Medicine and more

Rehabilitation therapy is key to recovery. We provide comprehensive rehab services for children:

  • Dedicated inpatient rehabilitation unit
  • 17,000-square-foot rehabilitation center with spacious physical therapy gym and an outdoor terrain park.
  • Outpatient therapy access at all locations

Find Us

Limb Lengthening

Limb lengthening techniques harness the body’s ability to heal itself through the regeneration of bone and soft tissues (e.g., skin, muscle, nerves, blood vessels, etc.). The concept of distraction osteogenesis involves the gradual pulling apart (distraction) of a surgically cut bone, allowing for the growth of new bone (osteogenesis) in the created gap. That new bone hardens or consolidates and is as strong as any other bone in the body.

Complex Reconstructive Surgery

There are several methods that may be helpful based on your child’s condition. These include changing the shape and alignment of the limb using a variety of techniques and implants. Additionally, soft tissues defects and deficiencies can be addressed through procedures such as soft tissues flaps, microvascular surgery and tendon transfers.

We offer expertise in the following techniques:

  • Guided Growth
  • Percutaneous Osteotomy
  • Remote Controlled Magnetic Lengthening Nails
  • Computerized Hexapod External Fixators
  • Hinged Distraction across Joints
  • Amputation Reconstruction
  • Bio Integrated and Expandable Prosthesis
  • Microvascular Surgery and Tissue Transfers
  • Masquelet Technique
  • Medical Botox Therapy
  • Electromyography
  • Advanced Physical Therapy
  • Customized Orthotics and Prosthetics
  • Prenatal Consultation

Conditions and Diagnoses

  • Limb length discrepancy (upper or lower limb)
  • Upper and lower limb deficiencies
  • Congenital leg length:
    • Congenital femoral deficiency (Proximal Femoral Focal Deformity) (PFFD)
    • Fibular deficiency/fibular hemimelia
    • Tibia deficiency/tibial hemimelia
  • Developmental limb deformities:
    • Blount's disease
    • Congenital pseudoarthrosis of the tibia
  • Acquired deformities:
    • Trauma including growth plate fractures, malunion (where the bones heal crooked), nonunion (where bone heals incompletely), shortening and deformity due to bone loss
    • Infection involving the bone (osteomylelitis) and joint (septic arthritis)
    • Soft tissue scarring such as after burns and multiple surgeries for club foot correction
    • Benign and malignant tumors
  • Short stature:
    • Achondroplasia and other skeletal dysplasias 
    • Limb length and angular deformities linked to dwarfism.
  • Pediatric hip disorders such as:
    • Developmental Coxa Vara (DCV)
    • Perthes disease
    • Slipped Capital Femoral Epiphyses (SCFE)
  • Limb differences linked with syndromes—many complex conditions have limb differences as one of their features such as:
    • Arthrogryposis
    • Osteogenesis Imperfecta
    • Amniotic band syndrome
    • Apert syndrome
  • Bone loss secondary to trauma, tumor or infection
  • Early stages of arthritis


UCSF Benioff Children’s Hospital Limb Lengthening and Complex Reconstruction Center is directed by Sanjeev Sabharwal, MD.

With over two decades of experience, Dr. Sabharwal has distinguished himself as a leader in the treatment of limb deformities in children. He is a frequent speaker at national and international symposiums on orthopedic medicine and past president of the Limb Lengthening and Reconstruction Society. He recently published a comprehensive clinical textbook covering all aspects of the management of pediatric lower limb deformities, Pediatric Lower Limb Deformities: Principles and Techniques of Management. Dr. Sabharwal serves as deputy editor for two eminent orthopedic journals, Journal of Bone and Joint Surgery and Clinical Orthopaedics and Related Research.

Dr. Sabharwal’s clinical research interests focus on advancing the science of limb lengthening and deformity correction, including distraction osteogenesis through clinical research and patient-centered innovation, developing patient-reported outcome measures for limb deformities and studying the motivations and impact of orthopedic volunteerism globally.