Discrepancy in length of the lower extremity can provide abnormalities in gait, cosmesis, and back mechanics. There are many varied attacks on this problem. Most of these have been basically aimed at either shortening the longer extremity, lengthening the short one, or a combination of both procedures.
Shortening the longer extremity can be done by actual bone shortening, by slowing growth by permanent epiphyseal destruction at the knee, or by temporary epiphyseal arrest at the knee. These operations have the distinct disadvantage of being performed on the normal or relatively normal extremity, and they also produce a person of permanently shorter stature.
Lengthening of the shorter extremity has been accomplished by direct surgical lengthening of the femur or tibia and fibula. A gain in the length of 2 or 3 in. can sometimes be attained in this manner. The various techniques of direct bone lengthening, however, are fraught with complications,
COOLEY JC, MUSSEY RD, ROGERS JCT. Femoral Arteriovenous Fistula Creation in the Treatment of the Short Leg: Experience with Seven Cases. AMA Arch Surg. 1960;80(5):838–842. doi:https://doi.org/10.1001/archsurg.1960.01290220130015
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