The “built” world is constructed for people around 5’6″ tall, give or take five to six inches. Those of us in that range never think about the height of a step, chair, or counter, nor do we have difficulty adjusting the car seat in order to reach the foot controls and steering wheel. Everything is designed for the average person.
Extremely tall people, however, can’t sleep in standard beds, can’t sit comfortably in theater seats, and have to duck going through doorways. People less than five feet tall have another set of concerns. In addition to possible issues regarding self-esteem, they cannot reach into overhead cabinets, sit in chairs with their feet on the floor, or control a car without special mechanical adaptations.
Once Dr. Ilizarov’s technique of bone lengthening caught on with surgeons world-wide (discussed in the last three blog posts), they began thinking about applying this technique to make extremely short people taller. For the most common form of dwarfism, called achondroplasia, grown men are, on average, 4’4″ tall, and women with the same condition grow to about 4′. These little people, as they prefer to be called, have normal intelligence and relatively normal trunk size. Their limbs are just extremely short despite having normal levels of the principal hormone that controls growth. The problem is that the bone cells do not properly receive the chemical message to get growing. This can occur through a new genetic mutation (parents of normal stature can have a short-statured child) or by an existing mutation that little people can pass from one generation to the next.
The condition has existed for millennia. For instance, a short-statured statue of an achondroplastic dwarf was among the findings in Tutankhamen’s tomb. Velazquez included two in a 17th Century court painting. In modern times, achondroplastic dwarfs have had roles as Oompa Loompas in Willy Wonka and the Chocolate Factory and as Ewoks in Return of the Jedi.
Using Ilizarov’s technique or spin-offs of it, the thigh bones and shin bones of little people can be lengthened, perhaps by as much as three inches each, thereby increasing the person’s stature by six inches. At that point, their heightened self-image may be dampened by their short arms, and some not-so-longer-little people go on to have their upper-arm bones lengthened as well.
The gradual lengthenings occur over many months and are typically performed in both thigh bones and possibly in both shin bones at the same time. During treatment, crutches are obligatory, and risks abound. Lengthen too quickly, and the nerves and muscles cannot keep up. Also the bone gap may not fill in with new bone. Lengthen too slowly, and the bone ends may heal to one another prematurely. Infection is always lurking. Even if no complications occur, the procedures are awesomely expensive and fiddle-intensive.
Furthermore, the lengthening is controversial among little people. Many are quite content with the way they are and find work-arounds to thrive in a world built for taller folk.
And then there are people without any form of dwarfism who just want to be taller. A scattering of doctors will accommodate them. I am not sure what Gavriil Ilizarov would think. Is his great idea that revolutionized the healing of difficult fractures now stretched beyond its limit?
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