Operative lengthening of the lower extremity and associated psychological aspects: the Children's Hospital experience.

Twenty-two patients underwent 23 femoral and tibial lengthenings by the Wagner technique from 1977 to 1987. Average length gained was 5.8 and 5.2 cm, respectively. Long hospitalization in addition to multiple operative procedures and a high complication rate created a significant psychological impact. Fourteen of 22 patients experienced psychological problems, primarily adjustment disorders, all of which resolved without long-term sequelae. Parental/family and nursing staff support were identified as the most important during the lengthening process. Advances in limb lengthening techniques may lessen the overall impact of this procedure, but preoperative psychological preparation is important.