[Progressive lengthening of the femur using Wagner's technic. Apropos of 48 cases]

Forty eight progressive femoral lengthenings using the Wagner technique have been performed on patients aged between 6 and 18 years (average 12 years). The main aetiology of the shortening was congenital deformity (25 cases). The mean lengthening obtained was 5.2 cm and the greatest was 11.2 cm. Lengthening obtained was more than 20 p. 100 in six cases with an extreme of 24 p. 100. The final discrepancy was always less than 25 mm. In 6 cases this was corrected by the addition of a contralateral epiphysiodesis or tibial lengthening. Weight bearing was resumed after an average of 5-6 months. Many complications occurred. Some were minor: sepsis in the pin tracks (14 cases) or varus derotation corrected at the end of lengthening (22 cases). Some were more severe: varus deformities of more than 5 degrees (8 cases), contractures at the knee or the hip corrected by tenotomies in the course of lengthening (2 cases), subluxation of the hip or knee (5 cases), fractures, delayed unions, non-unions without infection (7 cases). The major complications were 15 severe infections, 6 of them with fractures or non-unions and 5 neurological lesions.