Concierge orthopaedics · London
Limb reconstruction for congenital and post-traumatic deformity, by a fellowship-trained surgeon.
Correction of malunion, non-union, leg-length discrepancy and complex bone defects — Ilizarov and Taylor Spatial frames, PRECICE motorised nails, and acute correction, with plastics and paediatric input on the same corridor.
Why patients choose us
- 01
A fellowship-trained limb reconstruction surgeon
Not a general orthopaedic list. A consultant who does frames, lengthening nails and deformity correction as their main work.
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Plastics, microsurgery and paediatrics on the same corridor
Complex reconstructions need more than one specialty — soft-tissue cover, vascularised bone, growing-child planning all in one MDT.
- 03
Independent, and free
We are paid by no clinic, so the recommendation on frame vs internal nail vs acute correction is impartial and costs you nothing.
Indicative pricing
What private limb reconstruction costs in London.
Indicative ranges across our partner clinics. Send imaging and the deformity, and we quote firm figures across two or three technique options.
In short
A frame lengthening in our network: £18,000–£35,000, with a total pathway measured in months, not weeks.
| Procedure | Indicative range | Typical duration | Stay / turnaround |
|---|---|---|---|
| Planning consultation with long-leg X-rays | £350–£650 | 60 min | Same visit |
| CT with 3D reconstruction and deformity analysis | £700–£1,400 | 30 min scan | 3–5 days |
| Acute correction with plate or nail | £12,000–£22,000 | 2–3 hr | Inpatient 2–4 nights |
| Ilizarov / Taylor Spatial Frame application | £18,000–£35,000 | 2–4 hr | Inpatient 3–5 nights |
| PRECICE motorised intramedullary nail | £28,000–£55,000 | 2–3 hr | Inpatient 2–4 nights |
| Bone transport / Masquelet reconstruction | £25,000–£60,000 | 3–5 hr | Inpatient 4–7 nights |
Prices vary by device (frame vs PRECICE), by the length of construct, by inpatient stay and by whether soft-tissue cover or bone graft is needed. We come back with a firm quote once imaging is reviewed.
The problem
The right surgeon, the right device, the right timing.
Limb reconstruction is a subspecialty within a subspecialty. Volume, planning software and MDT access decide the result far more than the badge on the hospital door.
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Told to “learn to live with it”?
A limp, a leg-length difference or a healed-crooked fracture is not something you have to accept. Deformity analysis will show what is actually correctable.
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Frame or PRECICE nail — unclear?
Each has clear indications and honest trade-offs. We line up the choice against your bone, your soft tissues and your life, not the surgeon’s preference.
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Old fracture that never healed?
Non-union has a workup — infection screen, deformity analysis, mechanical assessment — before any fixation goes near it. That is what we get done, in order.
The journey
From planning to rehab — what happens, in order.
One surgeon from planning through distraction and consolidation to frame removal and rehabilitation.
Phase 1 · Planning
Imaging and technique choice
Phase 2 · Surgery and distraction
Osteotomy and gradual correction
Phase 3 · Consolidation and rehab
Frame removal and gait retraining
- 01
Planning
Planning consultation and imaging
Long-leg standing X-rays, CT with 3D reconstruction and deformity analysis — mechanical axis, CORA, magnitude and level of correction.
- 02
Planning
Technique agreed with you
Frame (Ilizarov / Taylor Spatial Frame), PRECICE motorised intramedullary nail, or acute correction with plate or nail — chosen for the deformity, age and soft tissues.
- 03
Surgery
Surgery — osteotomy and fixation
A controlled bone cut (osteotomy), frame or nail applied, bone graft or Masquelet spacer if there is a defect. Usually a general anaesthetic, one to three hours in theatre.
- 04
Surgery
Distraction phase begins (day 5–7)
The regenerate is stretched at roughly 1 mm/day in four turns. You or a family member does the turning at home, with weekly clinic checks.
- 05
After
Consolidation phase
Once length or alignment is reached, the frame or nail holds while new bone hardens — usually one month of consolidation for every centimetre gained.
- 06
After
Frame removal or nail retention
Frames come off in day surgery once X-rays show three cortices of healed regenerate. PRECICE nails stay in until the surgeon decides removal is safe.
- 07
After
Rehabilitation and gait retraining
Physiotherapy runs throughout — joint range, muscle strength, gait pattern. Return to full activity is measured in months, not weeks.
Typical end-to-end: 6–9 months from surgery to frame removal for a 5 cm lengthening. Full rehabilitation: months more.
When it helps
When limb reconstruction is the right step.
The situations we see most, plus one red flag that means an emergency rather than a routine appointment.
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Post-traumatic malunion
A fracture that healed in the wrong position — angulated, rotated or shortened — and now loads the joint abnormally.
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Non-union after fracture
A fracture that has not healed at nine months, or has stopped healing on serial X-rays — often needs bone graft and revised fixation.
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Chronic osteomyelitis
Deep bone infection with a sequestrum. Reconstruction combines debridement, antibiotic delivery and bone transport or Masquelet.
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Leg-length discrepancy
A difference of 2 cm or more, congenital or after trauma. Lengthening is offered by frame or PRECICE nail once skeletally mature.
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Congenital short femur or tibia
Congenital femoral deficiency, fibular hemimelia and related conditions — staged planning from childhood into adulthood.
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Blount’s disease and angular deformity
Progressive tibia vara and other angular deformities that fail bracing — corrected by guided growth in children or osteotomy in adults.
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Fibrous dysplasia and bone tumour reconstruction
Structural bone loss from benign disease or after tumour excision — reconstructed with graft, transport or vascularised bone.
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Red flag: deep infection after frame
Fever, spreading redness around pin sites or purulent discharge is not routine — needs same-day surgical review, not a routine appointment.
Technique options
Frame, nail, or acute correction — the right tool for the deformity.
What each option on the table actually involves — and which fits which problem.
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Ilizarov circular frame
The classic ring fixator — wires and half-pins hold the bone while it lengthens or corrects. Robust for infection, non-union and complex deformity.
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Taylor Spatial Frame
A hexapod ring fixator with software-planned struts. Six-axis correction of translation, angulation and rotation from a single mount.
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PRECICE motorised intramedullary nail
A magnetically driven lengthening nail inside the bone. No external frame — better for straightforward lengthening, in the right patient.
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Acute correction with plate or nail
For smaller deformities that can be cut and realigned in one sitting, then held with internal fixation. Faster recovery, narrower indication.
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Osteotomy and guided growth
A planned bone cut to change alignment. In growing children, small plates guide growth rather than cutting the bone.
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Bone transport (distraction osteogenesis)
A segment of bone is slid across a defect at 1 mm/day, growing new bone behind it. Used for large defects after trauma or infection.
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Bone grafting
Autograft (from your iliac crest), allograft or synthetic — added to non-unions or defects to give healing something to build on.
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Masquelet (induced membrane) technique
A two-stage reconstruction: a cement spacer first, then bone graft into the biological membrane it induces. For segmental defects.
Our vetted London network
A small panel of limb reconstruction surgeons, we picked them.
Fellowship-trained consultants across central London, with plastics, microsurgery and paediatric orthopaedics on the same MDT. Not listed publicly — introductions are made privately, once we understand your case.
Selection criteria
How we choose every surgeon in our network.
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Fellowship-trained limb reconstruction consultants, not general orthopaedic surgeons
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Access to plastics and microsurgery for soft-tissue cover and vascularised bone
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Paediatric orthopaedic input for growing-child planning where relevant
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Full frame service — Ilizarov, Taylor Spatial Frame, PRECICE nails and hybrid constructs
Safety and recovery
What to expect — honestly.
Limb reconstruction is a long pathway with well-described complications. Reporting the right things early is what keeps a manageable problem from becoming a big one.
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Pin-site care is the daily reality
While the frame is on, pin sites need cleaning to a set protocol. Minor redness is common; spreading cellulitis or discharge is not.
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Distraction is slow on purpose
Roughly 1 mm/day in four turns. Faster stretches the nerve; slower risks premature consolidation. The rate is not a suggestion.
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Consolidation takes longer than lengthening
Rule of thumb: one month in the frame per centimetre of length gained, and half that again to full weight-bearing.
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Joint stiffness needs work every day
The joints above and below the frame stiffen quickly if left. Physiotherapy is not optional — it is what protects your result.
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Nerve stretch can cause pain or numbness
The peroneal nerve is the classic worry in tibial lengthening. Any new numbness, weakness or foot drop is reported the same day.
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DVT and PE risk during immobility
Reduced mobility raises clot risk. You will be assessed for prophylactic anticoagulation and given exercises to keep the calf pumping.
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Refracture after frame removal
The regenerate bone is not yet full strength when the frame comes off. Protected weight-bearing continues for several weeks.
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Hardware can fail
Broken wires, loose pins or a struck PRECICE nail happen and are usually manageable — but need review, not a wait-and-see approach.
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Red flags
Fever, spreading redness, sudden loss of correction, new nerve symptoms or a calf that is hot and swollen — call the team the same day.
Reading your operation note
Your operation note in four parts. Read the last one first.
Whichever construct was used, the note the surgeon sends you keeps to the same shape.
A quiet reminder
Surgical language is precise and can read coldly — we translate it for you.
If you would like us to talk you through the note before your review, just ask.
- 01 Header
Indication and deformity analysis
Why the reconstruction was done — malunion, non-union, congenital shortening — with the mechanical axis, CORA and magnitude of deformity.
- 02 Technique
Osteotomy, fixation and construct
Where the bone was cut, what device was used (frame, nail, plate), any graft or Masquelet spacer, and the planned distraction and consolidation timeline.
- 03 Findings
Intra-operative findings and soft tissues
Bone quality, any infected or dead bone excised, soft-tissue cover, nerve and vessel status, and specimens sent for microbiology or histology.
- 04 Impression
Plan, distraction schedule and follow-up
Read this first: when distraction starts, the daily rate, when clinic and X-ray reviews happen, and the criteria for frame removal or nail retention.
Recognised by major UK insurers
Cover for limb reconstruction varies by insurer and by indication — usually funded when medically indicated (post-traumatic malunion, non-union, congenital deformity). We confirm cover, codes and pre-authorisation before booking.
Frequently asked
Everything we get asked about limb reconstruction.
Quick answers on frames vs PRECICE nails, timelines, cost, complications, and when to call the team urgently.
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What is limb reconstruction surgery?
A group of operations that correct the shape, length or alignment of a limb — using external frames (Ilizarov, Taylor Spatial Frame), internal lengthening nails (PRECICE) or acute correction with plates and nails. It is used for post-traumatic malunion and non-union, congenital shortening and deformity, infection and bone loss.
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What is distraction osteogenesis?
A planned bone cut is stretched at about 1 mm/day. The body lays down new bone (regenerate) in the gap. Once the target length or alignment is reached, the construct holds while the regenerate hardens — the consolidation phase — before the frame comes off.
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How is the technique chosen — frame or PRECICE nail?
It depends on the deformity, the bone, the soft tissues and your circumstances. Frames handle complex multi-plane deformity, infection and non-union best. PRECICE nails suit straightforward lengthening in a stable, uninfected bone. Acute correction with a plate or nail fits smaller deformities that can be realigned in one sitting.
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How long does the whole treatment take?
Longer than most people expect. Distraction adds roughly one week per millimetre planned, then consolidation adds about one month per centimetre gained. A 5 cm femoral lengthening is typically six to nine months from surgery to frame removal, plus rehabilitation on top.
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How much does private limb reconstruction cost in London?
Roughly £12,000–£22,000 for acute correction with a plate or nail, £18,000–£35,000 for a frame, £28,000–£55,000 for a PRECICE nail, and £25,000–£60,000 for bone transport or Masquelet reconstruction. Planning imaging is £700–£1,400.
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What are the common complications?
Pin-site infection, non-union at the regenerate, joint stiffness, nerve injury (peroneal nerve in tibial cases), DVT/PE, refracture after frame removal, hardware failure, malalignment and — rarely — deep infection or compartment syndrome. Most are manageable when reported early.
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Can children have limb reconstruction?
Yes — congenital deformity and paediatric trauma are a major part of the work. Timing matters: some corrections (guided growth) rely on remaining growth, others (large lengthenings) usually wait until skeletal maturity. Planning is done with paediatric orthopaedics.
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Is a PRECICE nail definitely better than a frame?
No — it is different, not universally better. PRECICE avoids the frame, the pin sites and the visible hardware, which matters. Frames handle infection, non-union and complex multi-plane deformity that a nail cannot. The right answer depends on your bone, not on a preference for either device.
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When should I call the team urgently?
Fever, spreading redness around pin sites, purulent discharge, sudden loss of correction, new numbness or weakness (especially foot drop), or a calf that is hot and swollen — call the same day. These are not things to wait out until the next clinic.
Related tests and treatments
Looking for something else?
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Clavicle fixation
Fixation of displaced or non-united clavicle fractures.
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Musculoskeletal MRI
Detailed imaging of bone, cartilage and soft tissue.
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X-ray
Standing long-leg films and fracture follow-up.
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All tests and procedures
Every test and procedure we arrange.
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Hypertension
Related condition guide.
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Type 2 Diabetes
Related condition guide.
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Blood Tests
Related diagnostic test.
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Health Assessments Select
Related diagnostic test.
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In practice, in London
What congenital and post traumatic deformity limb reconstruction looks like on the ground in London
For congenital and post traumatic deformity limb reconstruction, the private London route is mostly about consultant fit and hospital choice rather than raw waiting time. Waiting lists on the NHS for congenital and post traumatic deformity limb reconstruction vary widely by borough and by how the GP letter reads. Privately in London, we can normally offer a slot inside the same week, sometimes within 48 hours if there’s a cancellation. The difference isn’t clinical quality — the consultants are frequently the same faces you’d see on the NHS — it’s the calendar.
A private congenital and post traumatic deformity limb reconstruction pathway in London usually looks like this: an initial consultation, any diagnostics booked at a nearby facility (most within Zone 1 or 2), and a written report sent to you and your GP within a few days. The consultants we work with hold NHS posts alongside their private lists, which keeps the standards consistent across both settings. For congenital and post traumatic deformity limb reconstruction in particular, we bias towards consultants who do this every week rather than every month.
We’re careful about what a private pathway for congenital and post traumatic deformity limb reconstruction can and can’t promise. It can compress a wait, put you in front of a subspecialist quickly, and get a proper report in your hands within a week. It can’t rewrite what the imaging or the bloods say. Setting that expectation up front tends to make the whole experience less stressful.
Nearby in the library