[Progressive tibial lengthening in children (author's transl)].

The authors have studied 38 "simple" tibial lengthenings and 10 "iterative" tibial lengthenings in children, with the use of an external rigid distractor. Four out of five of these lengthenings have been performed in cases of constitutional shortness. The authors got an average lengthening of 4,2 cm (that is 17,5 p. 100) for first procedure and 5,5 cm (16,5 p 100) for iterative ones. Consolidation has been obtained after about 3 months and free walking was authorized after 6 months for simple lenghtenings. These delays are longer (5 months and 6 and a half months) for iterative lengthenings. The bone and articular complications observed are closely linked to the technic used. The authors recommended the use of an external distractor of Wagner type, an oblique osteotomy with ample oblique section and extensive tenotomies and aponevrotomies. Out of the author's own experience, the most frequent complications were: delay in consolidations, especially in acquired shortness, and foot complications, especially frequent on those patients with previous alterations at that level. Progressive tibial lengthenings must be, of course, part of a complete program of length equalization of the inferior limbs and must however be preceded by the necessary surgery to obtain rightness and stabilisation of the knee, leg, ankle and foot before starting the required lengthening.