Results of leg lengthening using Wagner's technique

Nineteen leg lengthenings by Wagner's technique were reviewed. Average patient age was 13 years (range, 8-18 years). The gain averaged 3.9 cm (range, 1.1-10 cm). Complications were prolonged treatment period (9 cases), metal-work failure (6), loss of gain (5), malunion (6), fracture (5), deep infection (2), and joint problem (6). The osteogenesis in the elongation gaps affected the results. No callus formation by 40 days after osteotomy and no bridging callus by the end of elongation period were warning signs of poor osteogenesis. All tibial lengthenings and femoral lengthenings of more than 5 cm or 13% of the original length were at risk of poor osteogenesis. Proper stabilization and bone grafting were the most effective measures for poor osteogenesis. Currently, Wagner's technique is not the treatment of choice because new techniques with fewer complications are available. However, Wagner's technique is useful in the cases to which the new procedures are not applicable.