Skip to Main Content

Limb Lengthening & Complex Reconstruction Center

The Pediatric Limb Lengthening and Complex Reconstruction Center provides comprehensive care for children and young adults with limb length differences or deformities of the arms or legs. We are the only multispecialty limb lengthening program on the West Coast dedicated specifically to pediatrics, performing more than 200 surgeries every year.

The conditions we treat require care from many types of specialists. Our team has the training and experience to use advanced techniques that enable our patients to reach their highest levels of function, mobility and comfort.

Our goal is to help children and young adults maximize their physical activity and functional ability using the least invasive approaches possible. We offer a full range of surgical and nonsurgical treatment options, including fully integrated orthotic and prosthetic services. We also have a comprehensive rehabilitation program to continue supporting our patients as long as they need care.

We welcome international patients seeking access to our innovative care. If you live outside the United States, UCSF International Services can help with coordinating this.

Explore what we do

A community for kids with limb differences

Our annual family picnic is a fun-filled day where patients, caregivers and providers share stories and offer support.

Advanced reconstruction techniques and collaboration among experts

Our team includes pediatric orthopedic surgeons with advanced skills in limb lengthening, deformity correction and complex limb reconstruction.

Because we are a large pediatric institution that serves the entire Bay Area and beyond, our patients have access to experts in numerous subspecialties. These include:

  • Pediatric orthopedics
  • Orthopedic trauma
  • Orthopedic oncology
  • Sports medicine
  • Hand surgery and microsurgery
  • Rehabilitation medicine
  • Physical therapy
  • Occupational therapy
  • Prosthetics and orthotics
  • Plastic surgery
  • Prenatal consultation

Rehabilitation therapy is key to recovery. We provide comprehensive rehab services for children, with amenities including:

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

Limb lengthening

Surgical techniques for limb lengthening harness the body's own ability to heal and regenerate bone and soft tissues (such as skin, muscle, nerves and blood vessels). The medical method called distraction osteogenesis involves the gradual pulling apart (distraction) of a surgically cut bone, allowing for new bone growth (osteogenesis) in the created gap. That new bone hardens and ultimately becomes at least as strong as any other bone in the body.

Complex reconstructive surgery

We use several approaches – both traditional and cutting-edge – to restore the anatomy and function of short and deformed limbs. We can change a limb's shape and alignment with a variety of techniques and implants. Additionally, we can address defects and deficiencies in soft tissues through advanced procedures, such as soft tissue flaps, microvascular surgery and tendon transfers.

We offer in-house expertise in the following techniques and services:

  • Computerized hexapod external fixators (orthopedic system that corrects deformities on multiple planes)
  • Remote-controlled magnetic lengthening nails
  • Joint preservation surgery
  • Guided growth surgery
  • Amputation reconstruction
  • Osteointegration
  • Advanced inpatient and outpatient physical therapy
  • Customized orthotics and prosthetics
  • Electromyography
  • Masquelet technique (a combination of a temporary spacer and bone grafting)
  • Microvascular surgery and tissue transfer
  • Minimally invasive surgery, including osteotomies

Conditions we treat

Our team is experienced in diagnosing and caring for pediatric patients with all types of limb disorders, including:

  • Acquired deformities, including those caused by:
    • Tumors
    • Infection in a bone (osteomyelitis) or join (septic arthritis)
    • Soft tissue scarring
    • Traumatic injuries, including growth plate fractures, malunion (poor alignment in a healed fracture), nonunion (an incompletely healed fracture), and shortening and deformity due to bone loss
  • Bone loss caused by an injury, tumor or infection
  • Congenital leg length conditions, such as:
    • Congenital femoral deficiency
    • Fibular deficiency (hemimelia)
    • Tibial deficiency (hemimelia)
  • Developmental limb conditions, including:
    • Blount's disease
    • Congenital pseudoarthrosis of the tibia
  • Hip, knee and ankle arthritis (early stages)
  • Limb differences linked to complex syndromes, such as:
  • Limb length discrepancies (upper and lower limbs)
  • Pediatric hip disorders, such as:
  • Short stature due to:
    • Achondroplasia and other bone growth disorders
    • Limb length and angular deformities linked to dwarfism


The Limb Lengthening and Complex Reconstruction Center at UCSF Benioff Children's Hospital Oakland is directed by Sanjeev Sabharwal, MD, MPH.

With more than two decades of experience, Sabharwal has distinguished himself as a leader in the treatment of limb deformities in children and young adults. He is a frequent speaker at national and international orthopedic medicine symposiums and has served as president of the North American Limb Lengthening and Reconstruction Society. He is editor of the comprehensive clinical textbook Pediatric Lower Limb Deformities: Principles and Techniques of Management. He also serves as deputy editor for the Journal of Bone and Joint Surgery, a leading orthopedic journal.

Sabharwal's research focuses on advancing the science of limb lengthening and limb deformity correction, including the technique of distraction osteogenesis. His research interests include examining patient-centered innovations related to limb lengthening, developing patient-reported outcome measures for limb deformities, and global orthopedics.


Our locations (4)

    Awards & recognition

    • One of the nation's best in orthopedics

    • Ranked among the nation's best in 10 specialties

    • limb surgeries performed each year

    Highlights of our orthopedic care

    Kid-focused care

    Our entire care team is specially trained to work with children. They understand growth and development, have expertise in pediatric conditions, and are skilled in the treatment approaches – both surgical and nonsurgical – that work best for young people.

    A broad network

    Our multiple locations across the Bay Area make it easy for families to access care. For those who live farther away, we also offer follow-up care through video visits and referrals to community-based orthopedic surgeons.

    Many experts under one roof

    At each of our facilities, patients have access to pediatric specialists, physical therapists and occupational therapists.

    Care for all ages

    We treat the full range of orthopedic concerns in pediatric patients ranging from newborns to young adults. We also ensure seamless care as our patients enter adulthood by coordinating with their new providers.

    International patients


    International Services

    If you're coming to UCSF from outside the U.S., we coordinate your child's appointments and provide other helpful services. Here's how to get started.


    Interpreter Services & Communication Assistance

    Interpreter services in many languages and TDDs are available for families that need help communicating with care teams. Here's how to access them.

    Plan your visit

    Preparing for your appointment

    What to Bring

    • Photo I.D.
    • Health insurance card
    • Insurance authorization, if required
    • Doctor's referral, if required
    • Recent test results related to your child's condition
    • List of medications, including dosages, plus any your child is allergic to
    • List of questions you may have
    • Device or paper for taking notes

    For visitors

    Before you head to the hospital, check out our guidelines for visitors and caregivers.


    Your Stay

    We offer valuable information to help you plan for your child's upcoming hospital stay. Find out about food services, family accommodations and more.

    Learn more

    Your Child's Care Team

    Our doctors, nurses, child life specialists and other providers have special training to care for children. Meet your child's care team.

    Learn more

    Interpreter Services & Communication Assistance

    Interpreter services in many languages and TDDs are available for families that need help communicating with care teams. Here's how to access them.

    Learn more

    Patient stories

    Anaka: A Unique Road to Recovery

    Read about the remarkable multidisciplinary effort at UCSF to help Anaka recover.

    Related clinics (1)

    orthopedic-clinic-320x320-2x 7

    Pediatric Orthopedic Clinic

    Pediatric Orthopedic Clinic

    San Francisco / Oakland / Greenbrae / San Ramon / Fremont / Walnut Creek...

    Support services

    Child Life Services

    Activity rooms, pet therapy and more to help kids feel at home.

    Child Life

    Certified child life specialists ease the stress and anxiety of childhood illness through therapeutic play, schooling and family-focused support.


    Camp Winning Hands

    This overnight camp is for children with congenital hand and upper limb differences. Kids make friends in a fun, safe and supportive environment.

    Family Amenities

    Family-friendly amenities help you relax and take care of yourself while staying close to your child. We offer lounges, kitchens, showers, breastfeeding rooms and more.


    Social Services

    Social workers ease the effect of illness, injury and hospitalization on your family with counseling and assistance to help you navigate the challenges.


    Activity Rooms

    Activity rooms offer a relaxed environment for children of all ages. Features include a playroom, digital arts studio and teen lounge. Find out more.


    Art Therapy

    Art therapy helps kids and families express themselves, making it easier to cope with pediatric health issues. Group and bedside services are available.


    Music Therapy Program

    Board-certified music therapists help kids cope with illness and the feelings that come with it. Find out about group activities and bedside therapy.


    School Program

    Our schoolroom services and individual learning programs help children hospitalized at UCSF continue their education and get ready to return to school.


    School Re-Entry Program

    We help kids return to school after hospitalization by educating staff and students about their needs and recommending needed accommodations. Read more.


    Individual Playtime & Instruction

    If your child can't be around other kids for medical reasons, you can sign up for private sessions in our activity and school rooms. Find out how.

    Family Resource Center

    We help families cope with the challenges of childhood illness and hospitalization in a relaxing environment where parents can get a much-needed break.


    Parent Support Program

    Weekly activities, including knitting, scrapbooking, chair massage and more, help family caregivers get a much-needed break. Find out more.


    Patient Relations

    Patient relations reps and nursing supervisors are here to answer questions and address concerns. Learn about your rights, how to reach us and more.


    Spiritual Care

    Chaplains help UCSF patients, families and staff cope with the spiritual and emotional challenges of childhood illness. Learn more.

    Translation, please

    We have interpreters for Cantonese, Mandarin, Spanish, Russian, American Sign Language and more.

    Request an interpreter