Tygerberg Hospital completes South Africa’s first fully internal limb reconstruction

Tygerberg Hospital, a flagship tertiary facility of the Western Cape Department of Health and Wellness (WCDHW), has reached a major national milestone by performing South Africa’s first fully internal bone transport and limb-lengthening reconstruction. This has been the only case of its kind performed in South Africa — across both the state and private sectors. In partnership with Stellenbosch University, the hospital now stands among only a few centres worldwide with the capability to perform this advanced limb salvage technique within the public sector. 

The patient, a 64-year-old former police officer, had lived with the long-term consequences of a severe gunshot injury sustained in 2018. Despite multiple surgeries elsewhere, he continued to struggle with chronic pain, an unhealed fracture, and a substantial difference in leg length that affected his quality of life. Surgeons reconstructed a 50 mm bone defect and corrected a 30 mm limb-length discrepancy. The fully internal device allows surgeons to complete both bone transport and subsequent limb lengthening without external frames, improving comfort, reducing complication risks, and shortening recovery.

Professor Nando Ferreira reflected on the significance of the achievement. “This operation demonstrates how far we have come in building world-class limb reconstruction capacity within the South African public sector. For patients who have lived for years with chronic pain and disability, advanced internal bone transport offers a genuine second chance at normal function,” Prof Ferreira explained. 

“Our unit was selected as one of only a few centres worldwide to use this procedure during its limited market release. This level of innovation reflects the strength of our surgical team, our academic partnership, and our commitment to delivering patient-centred care at an international standard,” he continued. 

Expanding on the clinical benefits, Dr Edward Fuzy explained how this method allows them to tackle complex bone loss in a single operation while avoiding many of the complications of traditional approaches. 

Tygerberg Hospital CEO, Dr Matodzi Mukosi, welcomed the milestone as evidence of the institution’s excellence: “This breakthrough highlights the incredible talent and innovation within our hospital. It shows what is possible when clinical excellence and strong partnerships work together for our patients.”

This success also reflects the Western Cape’s broader effort to build a health system that supports people throughout their life journey. 

Advanced trauma and limb reconstruction services play a vital role in helping residents live well by restoring mobility, dignity, and independence. The skills developed through this procedure could strengthen orthopaedic care for children who start life with congenital limb differences or experience early trauma, helping them start well. Older adults, who are increasingly vulnerable to injury and complex fractures, could benefit from safer surgical innovation that helps them age well with greater confidence and mobility. Achievements like this are only possible because the provincial health system continues to run well through strong governance, academic partnerships, and the commitment of clinicians who serve the 85 percent of residents who rely on public healthcare. 

For many patients in the Western Cape, particularly those from vulnerable communities who carry the long-term burden of trauma-related injuries, this breakthrough offers a realistic pathway back to work, independence, and improved quality of life. The newly regenerated bone is expected to form over roughly 100 days, followed by several months of consolidation. The case has already drawn international attention, underscoring the province’s growing leadership in surgical innovation and patient-centred care.