Femoral lengthening using the callotasis method: study of the complications in a series of 70 cases in children and adolescents.

The authors reviewed 70 femoral lengthenings performed for limb-length discrepancy in 66 children and adolescents using gradual incremental distraction. Nine were performed using the Judet lengthener and 61, the Orthofix external fixator. Etiology of the femoral shortening was congenital in 22, posttraumatic in 17, postinfection in 13, neurologic in 12, and miscellaneous in six. There were 83 complications, which were assessed as to their relation to the etiology of shortening, amount of lengthening, and age. The incidence of joint complications did not seem to be less than that previously encountered with rapid distraction methods of lengthening. Bony consolidation was achieved without additional surgery in 88% of cases. Delayed consolidation was most commonly encountered in children younger than 8 years old with congenitally short femora. The authors believe that good results can be obtained by incremental distraction by using uniplanar fixation by aggressive physical therapy, proper fixator application, and appropriate dynamization of the fixator.