Closed intramedullary shortening of the femur.

Closed intramedullary shortening of the femur in the adult provides a method for leg length equalization that poses minimal operative risks, maximizes healing, and produces an excellent functional and cosmetic result. The etiology of anisomelia and any associated abnormalities must be carefully analyzed preoperatively. A series of 40 closed intramedullary shortenings of the femur were performed; shortening averaged 3.3 cm (range 2.0 to 5.0 cm). Three patients had significant complications: delayed union in one patient required renailing; two cases of symptomatic external rotation deformity required correction. The technique for the procedure is demanding in terms of experience and equipment. Otherwise, intramedullary femoral shortening is an excellent method for managing adult anisomelia.