Caleb Meadows, 19, was born with a limb length discrepancy (LLD) and foot deformity many might think would hold him back from doing a lot of physical activity like playing soccer or basketball, but he’s never let it stop him from doing the things he loves.
Caleb was born with a condition known as fibular hemimelia. His right leg is 2 inches shorter than his left leg, and he only has four toes on his right foot.
“People often asked if it hurts because I had a big limp, but I controlled that limp and it didn’t bother me,” Caleb says. “I played soccer, basketball, football and my junior year of high school I did pole vault. It never stopped me from doing sports.”
The family turned to Children’s Healthcare of Atlanta in 2009 after relocating to Georgia from Mississippi. “My doctors at Children’s wanted to see how my leg was growing and if my right leg would ever catch up to my left leg,” Caleb says. “But, it always stayed 2 inches shorter.”
When the orthopedic team at Children’s realized Caleb’s right leg would not grow longer, they started talking to his family about the possibility of surgery to help lengthen his leg.
Jill Flanagan, MD, is a Pediatric Orthopedic Surgeon at Children’s who has special training and expertise to treat leg length discrepancies. Dr. Flanagan says this surgery could benefit Caleb by explaining that “with a leg 2 inches shorter, Caleb would always have a limp. In addition, he is at a higher risk for hip, knee or back pain due to his compensatory gait mechanics.”
In order to lengthen Caleb’s right leg, Dr. Flanagan recommended Caleb consider two possibilities: a procedure using an external fixator, which is a more common method of lengthening limbs, or a newer procedure using an internal lengthening nail and a magnet to lengthen the limb.
Dr. Flanagan is actively involved in research and new technologies for limb lengthening. “Limb lengthening is an evolving field,” she says. “There are still relatively few orthopedic surgeons who have the expert training needed for such intricate procedures. Just as important as the surgery is the need for a physical therapist that understands the nuances of lengthening. Children’s has the right level of expertise in both, which Caleb needed to make his lengthening possible.”
Children’s is one of only a few hospitals in the Southeast that commonly offers internal limb lengthening as an option to patients. Caleb needed to be skeletally mature (done growing) and wanted to wait until after his high school graduation to have surgery. After weighing the benefits the internal lengthening device could provide, Caleb decided to undergo surgery in June 2018.
“It’s cool that I was born with this situation and that I was able to decide which option to do,” says Caleb.
Doctors lengthened Caleb’s right tibia almost 6 centimeters during surgery and they are now waiting on his new bone to form. Every day, Caleb uses an external magnet by moving it over the top of his leg, which activates the magnetic gears inside the bone and extends the nail. These small expansions of the nail inside the bone slowly lengthen the bone over time and allow for new growth.
Caleb was on crutches for several months after his surgery, but started walking on his own just after Christmas 2018. He participates in physical therapy once a week at Children’s at Forsyth in Cumming, Ga., and doctors tentatively plan to remove the internal lengthening nail in December 2019.
“It’s been an amazing adventure,” says Caleb.
And, as a result of his experience at Children’s, which included learning quite a bit about X-rays and imaging, Caleb plans to begin studying radiology at Lanier Technical College this fall in hopes of one day pursuing a career in radiology.