Femoral lengthening by the Wagner method.

Lengthening procedures can yield excellent results, but are associated with potentially serious complications that require multiple operations and prolonged hospitalization. Femoral lengthening by the Wagner technique was performed from 1981 to 1987. The various complications and technical problems of 38 procedures in 37 patients were studied. Only 18 of the 38 procedures were uncomplicated. The main complication was related to the osteosynthesis with plates and screws in the second stage of the method, i.e., six broken plates, six minor pin-tract infections, two deep infections. The results were good in 28 procedures. To treat a leg length inequality, the physician must consider several treatment modalities, such as a lift for the short side. Each patient must be individually evaluated to select the adequate modality of surgical treatment including shortening or epiphysiodesis of the sound limb or lengthening of the shortened limb, procedures with relatively low morbidity.