UNC Chapel Hill: Genetic Collaboration Project On Height Influencing Genes (BREAKTHROUGH)

Scientists stack up new genes for height    (source link HERE, September 2010)

NOTE: We have to find that article!! (comes online on Sept. 29, 2010 in the journal Nature)

Update: I have decided to use the internet to look up the term” Genetic Investigation of ANthropometric Traits”

Filed under: Announcement, Research

Wednesday, September 29, 2010 — Competitors become collaborators to achieve a common goal: the discovery of genes that influence height.

CHAPEL HILL, NC — An international team of researchers, including a number from the University of North Carolina at Chapel Hill schools of medicine and public health, have discovered hundreds of genes that influence human height.

Their findings confirm that the combination of a large number of genes in any given individual, rather than a simple “tall” gene or “short” gene, helps to determine a person’s stature. It also points the way to future studies exploring how these genes combine into biological pathways to impact human growth.

“While we haven’t explained all of the heritability of height with this study, we have confidence that these genes play a role in height and now can begin to learn about the pathways in which these genes play a role,” said study co-author Karen L. Mohlke, PhD, associate professor of genetics in the UNC School of Medicine.

The study, which appears online Sept. 29, 2010, in the journal Nature, is the result of the largest consortium of researchers to ever study the trait. The consortium, aptly named GIANT for Genetic Investigation of ANthropometric Traits.

Traits, brought together hundreds of investigators from dozens of countries, to identify which genes affect height in almost two hundred thousand different individuals.

“These investigators had once been competing with each other to find height genes, but then realized that the next step was to combine their samples and see what else could be found,” said Mohlke. “The competitors became collaborators to achieve a common scientific goal.”

That pooling of resources was necessary because the scientists knew that height was a complex genetic trait, with possibly a number of genes of small effect each adding up to influence whether a person would be taller or shorter. In this large study, forty-six smaller genome-wide association studies of height were combined and then analyzed statistically, yielding 180 different regions or genetic loci that influence the trait. “These common gene variants could explain as much as sixteen percent of the variation in height,” said study co-author Kari North, PhD, associate professor of epidemiology in the UNC Gillings School of Global Public Health.

The researchers looked to see whether the 180 regions contained more genes that underlie skeletal growth defects than would be expected if those regions were just chosen randomly across the genome. They found that the genes were not random and could in fact point to functional pathways important in influencing height.

Members of the consortium are working to uncover the “missing heritability” – the proportion of inherited variation in height that is still unexplained. Because this study looked for common genetic variants, the researchers are now going after rare genetic variants that may also play a role.

“This work is giving the field important insights into skeletal growth, height and growth defects,” said Mohlke. “And it is also showing us how similar approaches can be taken to look for genes underlying other common traits and diseases relevant to body size, like type 2 diabetes.”

Also from UNC is co-author Keri L. Monda, PhD, research assistant professor in epidemiology in the Gillings School of Global Public Health. The research was funded by the National Institutes of Health.

Media contact: Les Lang, (919) 966-9366 or llang@med.unc.edu

Scientific Methods Of Height Increase (Written By Tarin)

Me: I was very surprised to find this article on inforbarrel.com located HERE written by an individual who went by the name of Tarin. It seems that this Tarin person is very knowledgeable on the subject of height, and the scientific research involved with possible height increase. It is not written by me and I am not sure if it is Tyler’s writing but it is spot on many of the ideas that I have looked into. If it is Tyler’s work and he wants me to take it down, I will. I know that infobarrel used to be a very big website which used to pay writers a reasonably high rate to write very content strong and detailed websites. Pat Flynn of Smart Passive Income was the person who introduced me to Infobarrel. He used to write articles for the website and has been paid a high 3 figure sum every month for stuff he wrote years ago. Pat, me , and Tyler (also Sky) have all at one point being in the internet marketing niche so I would guess a lot of guys who read the article post would realize it is actually an internet marketing strategy.

I think for the very beginner who is just starting to learn about the science of possible height increase beyond the stuff one can find in an E-product, this article is a great starting post to read and to get caught up on the ideas floating around. 

Scientific Methods of Height Increase

By Tarin Oct 6, 2010  0  0

It is often suggested that the only way to increase height is Growth Hormone or distraction osteogenesis surgery. However, there are way more methods to increase height than that. Just look at Michael Phelps, if there weren’t local factors within the growth plate effecting growth then he would be perfectly proportional. Michael Phelps however is not perfectly proportional. If only HGH affected human height than people with disproportionate wingspans to leg length would not be a possibility.

One way to increase height is by increasing serum levels of cGMP(by means of Nitric Oxide and Guanyl Cyclase) or by inhibiting cGMP inhibitors(like PDE5 which is inhibited by Viagra). cGMP is related cGKII and cGKII knockout mice suffered from dwarfism. cGKII increases chondrocyte hypertrophy by promoting chondrocyte hypertrophic differentiation.

Chondrogenic hypertrophy is one of the final stages of endochondral ossification(chondrocyte hypertrophy is also influencable by IGF-1 of which serum levels can be increased by recombinant growth hormone treated cow milk and other dairy products). The other stages are the resting zone(the hyaline cartilage growth plate line), the proliferating zone, and the ossification zone(there may be ways to induce growth in the ossification zone but I have not learned of them yet).

In the resting zone, it is possible to increase height growth by way of getting new stem cells into the hyaline cartilage growth plate line. This can be achieved by hydrostatic pressure, pulsed electric magnetic fields, or low intensity pulsed ultrasound. You can also affect the DNA replicative capacity by altering telomere length or by altering DNA Methylation status. These are affected by telomerase and DNA Methyltransferase respectively. Human Growth Hormone may affect DNA Methylation which could explain it’s role in Gigantism(HGH is involved in the feedback loop with IGF-1 as well).

You can also affect ion transport by pulsed electric magnetic fields. The Sodium Potassium pump has a profound effect on cell volume.

Then there’s the proliferative zone. It is speculated that chondrocytes have a finite proliferative capacity but there is evidence of some flexibility. The optimal level of estrogen may set chondrogenic proliferative capacity. Myostatin(also known as GDF-8) is inhibited by testosterone. Myostatin doesn’t only inhibit muscular cellular proliferation, it inhibits all cellular proliferation. Myostatin knockout mice were bigger and taller than the normal litter mates.

IGF-2, Lithium, and Puerarin may also affect height growth by their own mechanisms. IGF-2 is involved in an overgrowth disorder but it’s exact mechanism of inducing height increase is unknown to me. Lithium increases stem cell proliferation but inhibits thyroid hormone. Puerarin is a PI3K pathway stimulator which is anabolic to all cells.

You can see that there are several potential scientific methods that hold promise in height increase. Unfortunately, most of them orginated from cancer research and male enhancement formulas than by direct height increase research. Support Height Increase research!

Read more at http://www.infobarrel.com/Scientific_Methods_of_Height_Increase#GsTV0oGEsPTXE9Tu.99

Why LSJL Might Not Work, An Explanation Using Bone Mechanics And Bone Bridge Studies

Personal Message: I wanted to write this post as a final message to my own doubts of the effectiveness and feasibility of the LSJL method. After this, I will move away from talking about the method too much because I don’t feel I am qualified or knowledgeable enough on the subject to really study it in depth.

From this previous post HERE, Tyler and I had an exchange of emails back and forth with me trying to fully understand why the Lateral Synovial Joint Loading technique would or could ever even work. The main concerns I had were never put to rest and I wanted to make a clear statement for the readers now that there is quite a bit of data showing that by theory alone, the method should not work, at least at the level of understanding on how bone mechanics work at this point.

The reason is because of a type of effect from growth fractures known as bone bridges. I wanted to show the studies that have been done which showed growth plate fractures which caused what are known as ” bony bridge” which is a sort of like a real bridge that connects the bone epiphyseal end with the bone metaphyseal ends of the long bone together and they lead to almost completely stunted linear growth from just that small piece of bone connection. Before that they were technically separated by cartilage. It is also important to remember that even though the two bones are connected with bone, there is still an entire rest of growth plate surrounding the bone bridge, which doesn’t work well anymore,

The bony bridge effectively completely stopped the long bone from ever being able to lengthen, at least in that specific area where the epiphysis and metaphysis is attached.

What I am trying to say is that the LSJL method is effectively trying to push against bone that has completly surrounded it, in all 3 dimensions. Just from a broad general analysis point of view, I was arguing in the previous post with Tyler that the reasons growth plates work is that they completely seperate two pieces of bone. From a mathematically topological viewpoint I could say that the bones are solid in the radial direction but in the axial direction, they are completely separated by the growth plate. surrounding the 3 parts radially is the muscles and ligaments that go around it, but they are elastic and can stretch.

If we now look at how the method of LSJL is supposed  work (from my understanding after having the discussion with Tyler in the pervious post), chondrocytes proliferated and expanded in the epiphysis internal region of the long bone should be able to push the thick bone sorrounding it in the epiphysis in all directions 3 dimensionally out thus expanding out the  entire bone, but the LSJL method is hoping the epiphyseal bone will be the main parts that are suppose to be expanded. This means that the overall bone structure surroundin the chondrocyte and cartilage that is supposed to have developed has fundamentally changed, from not just 2 dimensionally anymore but 3 dimensionally Where there was once muscle which was elastic allowing for longitudinal stretching thus growth there is not bone, which is not as aleastic as muscle. That was my original concern.

For studies showing evidence that even a slight bone bridge between the two bone ends separated by the cartilage starts to get connected by the bone, growth is almost completely stunted. Topologically (and using some physics lingo) speaking the one direction the chondrocytes can expand in has been fixed with a constraint. If the originally perfectly aligned system of chondrocytes can’t even push past and beyond a bony bridge that has formed on just one side of the natural gorwth plates, what hope and effect does producing chondorcytes inside the epiphysis using LSJL can possibly have then where the bones are completely surrounding it?

As for the claim that Tyler has grown 1.5 inches from the Lateral Synovial Joint Loading, LSJL technique I really can’t explain that away. I could make the argument that there are plenty of stories of people who have gone through a slight or mini growth spurt really late in their 20s or even in their 30s. There are obviously some documented cases in the medical literature. One guy on a bodybuilding/ steroids internet forum/board talked about his mother who grew a little (1-2 inches) when she was in her mid to late 20s (can’t find the link at this time). If someone asked me to explain his (tyler’s) claim, another logical explanation to explain away the claim is to say that he is a liar and lying to you, but I would assume that Tyler is a honest person who would not lie about this type of thing, especially since he has been so dedicated for so long in finding a solution using real science and theory. I will just say that he is not lying to you. He is telling the truth about his height increase claim.

This reminds me of my claim behind the story of the Grow Taller Guru Lance Ward. He claims to be able to help you grow up to 6 inches within 90 days. I don’t know about that but in my review on him, I just guessed that when he was in his 20s, say 20 or 21, he felt dissatisfied with his height, he decided to do some streching and excercised and happend to go through an amazing growth spurt of 6 inches in a very short amount of time. If that really happened to him, then I would just curtly proclaim that he was just really lucky. He happened to be one of those people who wants to be taller, tried something out, was not supposed to grow anymore, but did grow and not just a little bit, but a lot in a really short time frame. If that is NOT the case, then I would say Lance lied about his story and did not increase in the 6 inches he claimed since he is really marketing his services in traditional internet marketing fashion which makes me distrust him.

I woudl guess that there are probably millions of below average height adolescent and teeenagers who secretly desire to be taller and try all sorts of exercises and stretching to increase in height. For some of them who are lucky and still have some growth left, they might be able to incerase by quite a bit of height. Michael Jordan desperately wanted to be taller (actually 7 foot) when he was a sophomore in high school being only 5′ 11″. He would hang on a bar in the house backyard and he grew 5 inches in 1 year but mostly in the summer. Dennis Rodman was said to have grown 10 inches in around 1 years time from the age of 20-22. Without that height he deinitely wouldn’t have been ever a NBA player .The 2012 NBA #1 draft pick Anthony Davis was a nobody in early high school being a 6’2 or 6′ 3″ point guard but his enormous and extremely lucky growth spurt of 7-8 inches shot him up to the best of the basketball world. Without the growth spurt, David might not have even been able to play college basketball. What I am trying to say is that maybe, just maybe that the growth that Tyler that has gotten is from just luck. There is always the arguement that life happens in strange ways. Sometimes strange things happen which look like miracles.

Now to play the devil’s advocate position against my previous argument…

Obviously the strange thing about his growth at such a later life is that unlike other people who might be in their late 20 s who have wanted to grown taller and did grow taller, he just happened to be one of the only people in the world who writes a Height Increase and Grow Taller blog/website and uses real science to find a solution. Not only that, he found a science and experiment backed possible height increase method and has been using it for years. If I was a betting man, I would say that the coincedence is too high. He has gotten something right, always assuming he has not been lying about his increase the entire time.

What are the chances that a guy who wants to be taller, does exercises to be taller and really tries, was in his middle to late 20s when he started doing the exercies, who also writes one of the only blogs or websites on the entire internet looking for a height increase solution, is knowledgeable on the real science of human growth, who also has found, claimed, and documented that he has growth in height which is beyond the range of measurement error, and if he is also being completely honest nad not lying about his claim, did actually grow???

How is it possible to just say that all of this was just by pure chance, only randomness. Randomness is the 25 year old women who is happy with her height, never searchs for any height increase information, barely exercises much, and find that she has grown 1-2 inches in her mid to late 20s. That is randomness.

What is supposed to happen with him is too improbable to be just chance or random luck (again, obviously assuming that he is not lying about his increase). He definitely has something which I can’t explain away. I want to prove that the technique/ method doesn’t work but I can’t and I don’t want to disprove it if I can help it. The method gives real hope to people out there who are already physically mature but want to increase their height without the incredible complications that is involved with limb lengthening surgery.

From source link HERE

Premature Partial Closure and Other Deformities of the Growth Plate: MR Imaging and Three-dimensional Modeling

  1. Joseph G. Craig, MB, ChB1, Kathryn E. Cramer, MD2, Dianna D. Cody, PhD1, David O. Hearshen, PhD1, Ruth Y. Ceulemans, MD1, Marnix T. van Holsbeeck, MD1 and William R. Eyler, MD1
  2. Departments of Radiology (J.G.C., D.D.C., D.O.H., R.Y.C., M.T.v.H., W.R.E.)
  1. Orthopaedic Surgery (K.E.C.), Henry Ford Hospital, 2799 W Grand Blvd, Detroit, MI 48202.

Abstract

PURPOSE: To examine growth plates of the distal femur and tibia with magnetic resonance (MR) imaging to detect bone bridges and other deformities in children.

MATERIALS AND METHODS: Thirteen children (nine boys and four girls, aged 5–13 years; mean age, 9.8 years) were referred because of suspected or known bone bridging of the growth plate. Among the 13 patients, 10 had Salter-Harris fractures of the knee or ankle, two had Blount disease, and one had neonatal sepsis. Fat-saturated spoiled gradient-recalled images enabled reconstruction of a three-dimensional model of the growth plate. Patients underwent one to four MR examinations.

RESULTS: Nine patients had bone bridging of less than 1% to 39% of the area of the growth plate. On MR images obtained in the growth plate of five patients, a stripe of low signal intensity indicated fracture. On MR images obtained in three patients, intrusions of growth plate cartilage into the metaphysis were seen to increase in depth over time. MR images obtained in four patients showed no bridges. In the two patients who underwent surgery, excellent correspondence was found between MR findings and surgical observations.

CONCLUSION: Marked undulation or splitting of the growth plate may occur with fixation of some cartilage in the metaphysis or epiphysis while growth continues. The configuration of the growth plate and bone bridges can be accurately mapped with MR imaging. Treatment planning is facilitated.

Growth arrest followed physeal injury at the knee and ankle in 1.4% of the large series of patients studied by Mizuto et al (1). The occurrence of arrest following Salter-Harris fractures at the knee and ankle is related to many factors, including the type of physeal fracture, the age of the patient, the physis involved, and the amount of energy applied to the bone (2,3). The knee is the most common site of growth arrest (4,5), with the ankle second (4). The development of bone bridges at these sites results in interference with longitudinal growth (4,5).

Physeal fracture is the most common cause of bone bridging across the growth plate, but growth arrest may also be due to other insults, as reported by Ogden (5,6). Such insults include infection, therapeutic irradiation, metabolic or hematologic abnormality, tumor, burn, frostbite, electrical injury, sensory neuropathy, microvascular ischemia, or insertion of metal. Pease (7) reports premature fusion of the growth plate in patients with hypervitaminosis A. Caffey (8) describes cupping of metaphyses following trauma, osteomyelitis, poliomyelitis, vitamin A toxicity, sickle cell anemia, achondroplasia, or osteopetrosis.

If the growth plate is affected eccentrically, tethering will cause angular deformity. If the growth plate is affected centrally, growth at the periphery causes cupping of the metaphysis with shortening of the bone (5). The younger the child, the more severe the complications.

Plain radiography remains the initial imaging approach. Interpretation problems arise if part of the physis is not parallel to the x-ray beam. The presence of growth arrest lines is helpful; if a growth arrest line extends across the entire metaphysis and is parallel to the physis, physeal bridge formation is unlikely (9). As needed, results can be compared with the normal appearance of the growth plate (10,11).

If surgical excision of a physeal bridge is considered, accurate knowledge of its size and position is necessary. Conventional tomography with grid mapping (12), bone scintigraphy (13), and computed tomography with reformatting (14–16) have been used for this purpose. MR has been used to image the growth plate (3,17) and has now become the imaging method of choice (18).

We present our findings in children at high risk for bone bridging in whom we obtained one or more MR studies and 3D models of the growth plate to determine the need for intervention.

From the Ortho Facts Website HERE

Long-Term Outcome

Growth plate fractures must be watched carefully to ensure proper long-term results.

In some cases, a bony bridge will form across the fracture line that prevents the bone from getting longer or causes the bone to curve. Orthopaedic surgeons have developed techniques to remove the bony bar and insert fat, cartilage, or other materials to prevent it from reforming.

In other cases, the fracture actually stimulates growth so that the injured bone is longer than the uninjured bone. Surgical techniques can help achieve a more even length.

Regular follow-up visits to the doctor should continue for at least a year after the fracture. Complicated fractures (types III, IV, and V) as well as fractures to the thighbone (femur) and shinbone (tibia) may need to be followed until the child reaches skeletal maturity.

 

From the website for Wheeless Textbook For Orthopaedics on the subject of Physeal Bone-Bridge…

Physeal Bone-Bridge


– Discussion:
– bone bridge obliterates growth-plate cartilage & prevents growth;
– peripheral bone bridges predispose patient to angular deformities;
– most common sites of growth arrest include the distal tibia, distal femoral and distal ulnar physis;
– much less common sites include distal radius and proximal humerus;– Radiology:
– extent of bone bridge is demonstrated by CT scanning and tomograms;
– Indications for Bone Bridge Resection:
– resection is indicated if less than 1/3 to 1/2 of growth plate is involved;
– younger children tend to have a better prognosis w/ resection than older children;
– less than 2 years of remaining growth is a relative contra-indication for bone bridge resection;
– central bars are more amenable to resection than peripheral bars;
– ischemic or septic related bone bars have a poor prognosis w/ resection;– Technical Pearls:
– interposition of fat is easiest and most commonly used agent to prevent bone bridge formation (alternatives include silastic, methyl methacrylate, or free epiphysis)

Limb Lengthening Story: A Tall Order Comes True, Christy Ruhe, From 4’3″ to 4’10”

I found this story about Christy Ruhe who had achondrosplasia which made her just 4′ 3″. It is from the website limb lengtheningdoc.com which is one of the websites that is for Dr. Dror Paley. I looked a little further and found the LA Times sotry from 2004 from this link HERE.
THE NATION

Christy Ruhe was born with a form of dwarfism that left her 4-foot-3. She opted for painful, controversial surgery to grow.

February 15, 2004|  Gretchen Parker | Associated Press Writer

PICKERINGTON, Ohio — Limb-lengthening surgery is controversial among dwarfs, and it is painful. Still, many choose to undergo the bone-breaking and difficult therapy to gain inches in height. One patient who made this decision, Christy Ruhe, allowed an Associated Press reporter and photographer to closely follow her two-year progress. This is her story.

PICKERINGTON, Ohio — The tiny, silver BMW roadster slides out of the garage and zips toward the freeway. Christy Ruhe adjusts the rearview mirror and rests one hand on the steering wheel. The car, her dad’s, is a perfect fit. She looks like she’s been driving it forever.

Two years ago, she couldn’t have reached the pedals.

Christy recently finished a procedure that surgically broke her bowed legs, then stretched and straightened them, an agonizing ordeal that would leave even her questioning how much she could endure.

Once 4-foot-3, she’s now just 2 inches shy of 5 feet.

She had always craved just a few more inches. Enough to drive any car and pump her own gas, or reach the pedals under the piano. Practical things, but seven inches would accomplish so much more.

To understand why Christy would put herself through the grueling surgeries and therapy is to understand a spirit determined to be as independent as possible.

Christy was born with achondroplasia, one of 200 forms of dwarfism. Her arms grew in proportion to her torso, but her little legs were severely bowed. At 5, surgeons broke her hips and realigned them. At her sixth birthday party, she lay in a full body cast.

But the more she grew, the more stubborn her legs became — always bending outward.

Limb lengthening might help straighten her legs, her pediatric orthopedic surgeon said, but he discouraged the idea.

“His reasoning was: ‘Why would you want to put yourself through that?’ ” said her mother, Rita Ruhe (pronounced ROO-ee).

The procedure is controversial. The advocacy group Little People of America has taken an official stand against it, warning of the risks of long-term nerve and vascular damage.

But Christy, who lives in Pickerington, near Columbus, couldn’t get the idea out of her head.

Everything she did reminded her of the limitations of being 4-foot-3 in a world where most adults are at least a foot taller. She needed a footstool to wash her face at the bathroom sink or to flip a light switch. To drive a car, she needed extension pedals.

Her parents are not dwarfs; neither is her willowy older sister, Erin.

John and Rita Ruhe nurtured their daughter’s independence. But outside the Ruhe house, Christy would learn about alienation. Strangers would stare. Her legs were weak and, on walking trips, she lagged behind.

“I always felt like, why do I have to explain this? Why do I even care what they’re saying?” she said. “I did, of course. It’s impossible not to.”

At 22, Christy contacted Dr. Dror Paley and the International Center for Limb Lengthening, the clinic he co-founded with two other orthopedic surgeons at Sinai Hospital in Baltimore.

It’s now late September of 2001. Christy is focused on the changes unfolding in her own life, and the anticipation of her first limb-lengthening surgery is thrilling.

Her hospital gown drags on the floor as she slides off the bed onto a stepstool. She smiles widely at her nervous parents.

In the operating room, Paley’s plan is to break the thigh and shin bones of her left leg and stretch the bones for three or four months as they’re healing. A year later, he’ll lengthen the right leg.

Limb lengthening works by taking advantage of the body’s natural tendency to heal itself. The shin bones and femurs are broken and automatically begin to generate new bone. As they heal, they’re pulled apart to elongate them. The surgeries, which typically cost about $200,000 for both legs, are covered by insurance.

Paley cuts holes in Christy’s leg so that he can screw rods into the bone: seven in her thigh and five in her shin. Each is a foot long. Half the length protrudes from her skin, so Paley can attach them to a graphite brace that Christy will crank.

Paley bores the pins deep into the thick whiteness he sees on the X-rays.

Finding a good place to crack the bone, he first drills a tight chain of small holes. He puts a chisel to the perforation and pounds it hard with a mallet. The whirring and hammering make it sound like a construction site.

The pain is like an ocean that sucks her under again and again.

Christy lies on her stomach, and a physical therapist bends her knee as far as it will go. Muscles and nerves are stretching to meet the length of the new, soft bone.

The therapist pushes until she feels the soft tissue become elastic. It’s been only a few days since the first surgery.

Christy’s face reddens, and she rides the wave of pain with short breaths. She tries not to scream but can’t stop herself.

She wonders if the therapist knows what she’s doing. “This cannot be right!” she thinks.

(Page 2 of 2)

There’s little blood and not a lot of cutting in limb-lengthening surgery. But recovery is an extended test of mettle and will.

Christy will go through the agony twice. She knows that if she survives even the worst day, there will be another just like it a year from now.

Each day brings a monotony she comes to dread: therapy, broken up by hours of MTV and talk shows. She gets around in a wheelchair. Four times a day, she uses an Allen wrench to turn the brace and stretch her leg.

The growth of bone and muscle tissue is measured in millimeters — 1 mm a day — but Christy doesn’t feel it.

She smiles less these days, snaps at her parents and then regrets it.

She can’t sleep. The steel rods sticking out of her legs keep her from rolling over. She worries about jarring them, which sends slivers of pain up through the sore muscles.

Quitting is not an option.

“You have those moments when you say, ‘I can’t do it anymore. I can’t stand it,’ ” she said. “You have to look back at why you’re doing this. It’s for my health, my well-being.”

Before the surgeries, she talked herself into being resigned to a hard life. Now, the change in her body seems like an extraordinary gift. She reminds herself that the pain is temporary.

Gradually, she realizes how different her life will be. She even dreams differently now, seeing the world from her new height, as a person who blends into a crowd.

Most of Paley’s patients are children, and they crowd into the waiting room at the International Center for Limb Lengthening.

They come from nearly every continent. Little girls, with one shorter leg wrapped in a pink or purple cast, bring their Barbie dolls. Adult patients sit with their afflicted legs propped on a seat, rods penetrating the skin, machinery that looks misplaced inside healthy, smooth flesh.

It is spring of 2003, a year and a half after Christy’s first surgery, Her left leg, the one already lengthened, is straight and muscular. The leg is a promise to her that the surgeries will be successful.

But a chronic infection has developed in the skin around one rod in the right leg, which was operated on six months ago. Christy knows the rod must be removed.

The procedure will be done without general anesthesia, which always makes Christy’s stomach roil. The doctor expects this to be a quick procedure anyway, hardly worth administering even local anesthesia.

Paley attaches a T-shaped handle to the troubled rod. With the first turn, Christy begins to shriek. As the rod twists through bone, muscle and infected skin, she lets out short, piercing screams.

With one arm, John Ruhe tries to immobilize his daughter’s good leg and wraps his other arm around her shoulders. Her fist slams his chest as the pin turns.

Three minutes later, the end of the 12-inch pin appears. The hole in her thigh looks like a gunshot wound. Hot, red blood starts to roll out.

Christy’s back slumps. Her eyes are closed.

It’s two months later, and Christy is undergoing what she thinks will be her final surgery. The hardware that has become her second skin is to be removed.

But on an X-ray, Paley examines a hazy, white patch on the right thigh bone. Eight months of therapy should have left it solid — healed — but it isn’t.

Christy is unconscious a few feet away in the operating room when Paley makes the decision. If he takes the pins out now, the leg will break when she walks on it. They will have to wait at least two more months.

A banner at the party reads, “Congratulations Christy.”

It is a 25th birthday celebration, but the occasion also marks the end of her surgeries and crutches.

Friends and family who have supported her through an ordeal they can barely fathom write messages on a plastic sign.

“Good luck, and have a wonderful rest of your life,” says one.

“In my eyes, you’ve always been tall,” says the only note that hints at her physical transformation.

“You are my hero,” her sister writes.

All eyes are on Christy as she arrives. She steps carefully on her new legs. The right leg is still weak, but growing stronger.

Later, she says she doesn’t remember all of the pain she endured. Time has dulled the memory, and she prefers to look forward — to a life that she hopes will be easier, now that she’s in an adult-sized body.

She takes a second to place the faces before flashing her hundred-watt smile, a picture of self-assurance. “To me, I am tall,” she said. “I am a tall person now. That’s all that matters.”

Increase Height And Grow Taller Using Callus Distraction, Callotasis

Me: I wanted to go deeper into the research behind what types of surgical methods are available for limb lengthening and my searching is starting to lead me to some surgical methods I have not been aware of before. The new idea that I learned about is that of Callus Distraction, or Callotasis. It is important to realize that most forms of distraction osteogenesis operates on the callus principle. Limb Lengthening for orthopedic surgeons who specialize in the area is actually a very large area of study. There seems to be at least a dozen even more specific types of surgical methods for limb lengthening. 

The Callus method means that after you make the distraction past the peristeum (why they call it subperiosteal) and past the cortical bone (why they call it submetaphyseal) you hold the two ends close to each other and let the bones heal and create a callus. The callus that is formed gets pulled before it starts to get hard adn inelastic  from the calcium salts. Slowly more callus will develop from the distraction of the callus. You are supposed to keep the trabecular spongy bone and cavity intact. 

From source link HERE

Clin Orthop Relat Res. 1989 Apr;(241):137-45.

The callotasis method of limb lengthening.

Aldegheri R, Renzi-Brivio L, Agostini S.

Source

Center of Pediatric Orthopaedics, Institute of Clinical Orthopaedics and Traumatology, University of Verona, Italy.

Abstract

Callotasis is a lengthening technique that involves slow, controlled distraction after subperiosteal-submetaphyseal osteotomy. The technique and its advantages over other methods are described. Results of lengthenings involving 270 operated bone segments (146 femurs and 124 tibias) in 140 patients are reviewed. Ninety-five patients had limb-length inequality and 45 had hypochondroplasia or achondroplasia. On average, 6.6 cm, or 24.6% of initial length, was gained. The mean healing index was 39; the complication rate was 13.3%.

PMID:   2924457       [PubMed – indexed for MEDLINE]
Me: It appears that callotasis is a very popular approach for people who have some form of dwarfism. 
From source link HERE
J Pediatr Orthop. 1987 Mar-Apr;7(2):129-34.

Limb lengthening by callus distraction (callotasis).

De Bastiani G, Aldegheri R, Renzi-Brivio L, Trivella G.

Abstract

Callotasis is a new technique of limb lengthening involving slow distraction of the callus formed in response to a proximal submetaphyseal corticotomy. Using a dynamic axial fixator with telescoping capabilities, distraction begins after 2 weeks. When the required length is attained, the fixator is held in the rigid mode until radiographic evidence of callus is observed. The locking screw is then released, and dynamic axial loading is instituted to promote corticalization. One hundred bony segments have been lengthened; 50 patients had limb length inequality, and 23 had achondroplasia. The mean lengthening achieved was 22% (maximum, 58%). There were 14 complications (14%).

PMID:  3558791       [PubMed – indexed for MEDLINE]
From Ilizarov Jordan website
Callotasis

a distraction osteogenesis technique that involves gradual stretching of the reparative callus, which forms around bone, segments interrupted by osteotomy or nonunion fracture. The main complications of this period are axial deformity of lengthening segment, pin tract infection and fixator unstability.

From source link HERE
We can see the different ways the distraction can happen and what would happen if the distraction is done improperly at different speeds.