Leg-lengthening procedures. A historical review.

While there are new techniques for lengthening long bones, there are, nevertheless, contraindications and preoperative considerations for lengthening the femur or tibia, such as the presence of acetabular dysplasia, fixed deformity around joints, peripheral vascular and metabolic bone disease, and the age of the patient. Lengthening a long bone may be associated with many complications, especially in a congenitally short bone. It is important to anticipate and prevent complications, especially nonunion, subluxation of joints, muscle contractures, and neurologic complications. Lengthening of the femur and tibia are not for the occasional operator. However, as Bosworth noted in 1938, attention to great detail when lengthening the bone and skilled and detailed postoperative care will allow excellent results to be obtained. Time alone will tell what, biologically, is the best method for lengthening a long bone.