[Wagner's method of leg lengthening in young children]

In 22 children under the age of 10 years a Wagner leg-lengthening procedure was started at a time when the orthosis became a nuisance. In all cases a discrepancy of more than 7.5 cm was expected at the end of growth, and an end result with full weight bearing and a minimal adjustment seemed to be within reach. In 9 children this aim has already been attained, 12 children are still under treatment and one child withdrew after a femoral lengthening complicated by an ankylotic hip joint. An account is given of a total of 35 procedures (16 tibiae, 19 femora). Complications can be prevented, or at least controlled, by careful lengthening, not exceeding 15-20% of the original length of the bone. The technique of diaphyseal callus-distraction reduced the gap-healing time to less than 6 months, while it diminished the need for cancellous bone-grafts and internal fixation. Furthermore, in at least 4 patients such a growth stimulus was observed after femoral lengthening, that a second procedure was not necessary.