Center for Excellence in Limb Lengthening and Reconstruction

Texas Scottish Rite Hospital for Children began its limb lengthening and reconstruction research program in 1992. Initial research was based on the Ilizarov treatment method developed by Dr. Gavril Ilizarov in Russia. Three physicians that trained under Dr. Ilizarov joined our TSRHC research team.
Driven by the goal of making the entire lengthening process easier for the patient, TSRHC researchers have modified Ilizarov's technique to develop the TRUE/LOK External Fixation System. In 2003, the hospital formed the Center for Excellence in Limb Lengthening and Reconstruction (CELLR), directed by Dr. John Birch and Dr. Mikhail Samchukov. With the transition of Dr. Birch from Active to Affiliate Medical Staff in 2015, Dr. David Podezswa assumed his role. The center continues to focus on improving lives of patients with various limb deformities and leg lengths discrepancies. CELLR research areas include refinement of current fixation systems, improvement of limb lengthening techniques, better management of limb deformities.

CELLR Activities 

Day to day work of The Center of Excellence in Limb Lengthening & Reconstruction is comprised of the three groups of activities: Research, Clinical Support and Education


Discovery of the fundamental biological mechanisms and controlling parameters of new bone formation and soft tissue adaptation under the influence of tension stress.

Clinical Support

Implementing new and improving existing techniques of limb reconstruction, distraction osteogenesis, and external skeletal fixation.


Developing and delivering comprehensive interactive curriculum to share the knowledge with local, national and international orthopedic communities.


For more than 25 years, the center conducted and successfully completed over 60 research projects, holds 20 United States and International patents, while another 33 patents are pending. Results of the center's accomplishments have been presented at numerous national and international meetings and published in one book, 50 book chapters, 64 peer-reviewed journal articles and more than 220 published abstracts. The center’s scientific and clinical progress has placed the TSRHC in a strong leadership position in the area of limb reconstruction research and development in the United States and worldwide.

TRUE/LOK External Fixation System

In 1993, by modifying Ilizarov’s original external fixator, TSRHC research team developed and patented a new device called the TRUE/LOKTM External Fixation System (TrueLok). The device was created to treat deformities and extremity trauma and to lengthen limbs with a simpler but more adaptable fixator. Subsequently, TrueLok was enhanced by innovative software - computerized deformity correction planning - empowering the surgeon with objective control throughout pre/intra/post operation phases. Intraoperative neurological monitoring developed by researchers of the Center offered additional support for proper frame application without accidental nerve damage. Within consecutive decade TrueLok continued to evolve and become easier in assembly and management but more stable and comfortable to the patient. In 2012, the TrueLok was augmented by three-dimensional bone segment adjustment module called TL-HEX. As any other hexapod-based system, TL-HEX required complex 3-dimentional software. TL-HEX Software was developed in collaboration with Orthofix Inc (USA). and New Orthopedic Instruments (Russia). Currently, TL-HEX represents the most advanced external fixation system in the field of orthopedics. In essence, it consists of circular and semi-circular external supports secured to the bones by wires and half pins and interconnected by six struts. This allows multi-planar adjustment of the external supports. The rings position is adjusted either rapidly or gradually in precise increments to perform bone segment repositioning in three-dimensional space. Further development of TRUE/LOKTM External Fixation System lead to the design of TL-Ttrauma (TL-T). The system was created to secure fractured bone segments in emergency situation as a temporary spanning fixator. Stability of the TL-T frame allows in the majority of case to use it as a definitive treatment solution. Continuous development of the TRUE/LOKTM External Fixation over the years extended TSRH recognition in the are of limb reconstruction both in the USA and worldwide.  

For More Information

Please view a PDF of information on the Center for Excellence in Limb Lengthening and Reconstruction or call the Research department at 214-559-7877 or 800-421-1121, ext. 7877.