Surgical Correction of Large Length Discrepancies in the Lower Extremities of Children and Adults

The procedures used to correct large discrepancies in the lengths of the lower extremities are described and the results in twenty consecutive patients are reported. It is concluded that discrepancies of up to twenty centimeters can be corrected surgically so that the patient can wear normal shoes. As much as ten centimeters of correction can be achieved by a one-stage bilateral procedure without excessive risk, provided certain technical precautions are strictly observed. Lengthening of the tibia up to six centimeters is safe even in young adults if a decortication two-stage technique is used. Varus and valgus deformities of the knee and femoral neck must be corrected, sometimes repeatedly during the growth period whenever sufficient angulation develops. The results in twenty patients, six to thirty-three years old, whose discrepancies ranged from seven to 22.6 centimeters, are reported.