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The evolution of bone-lengthening techniques in the history of orthopaedic surgery reflects the need to address the often challenging problem of limb shortening. Femoral shortening results from congenital, traumatic, or other conditions of the musculoskeletal system as well as the adverse effects of the functional status of the patient. The goal of any orthopaedic intervention is functional recovery, ideally with reconstitution of the normal anatomy of the lower extremity, by an efficient, safe, and simple procedure. Detailed evaluation of the deformity and the patient is essential to select the most appropriate technique and formulate a meticulous preoperative plan. This, combined with technical expertise, close postoperative monitoring, and patient cooperation will yield the best possible outcome. One-stage techniques may be useful for lengthening up to 4 cm. The Ilizarov method is a well-established versatile technique that can accomplish a considerable amount of lengthening. However, it is a technically demanding procedure fraught with common complications. Innovative techniques have been recently described, such as Ilizarov lengthening over an intramedullary nail and the use of a gradual elongation nail. |
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