Closed shortening of the femur.

Twenty skeletally mature patients (average age, sixteen years and seven months; range, thirteen years and seven months to twenty-two years and four months) were treated for limb-length inequality by closed shortening of the femur. Preoperatively, the amount of femoral shortening that was necessary to level the pelvis was determined radiographically by balancing the pelvis with calibrated lifts under the shorter extremity. All twenty shortening procedures were performed with an intramedullary cam saw and insertion of an intramedullary rod through a gluteal incision; no additional incisions were needed to complete the procedure. At the most recent follow-up, the limb-length discrepancy was one centimeter or less in all twenty patients. All patients reported that the limbs seemed to be of equal length and that the pelvis felt level.