[Transepiphyseal lengthening of the tibia. Apropos of a case]

Most tibial lengthenings are undertaken at the level of the diaphysis but in some cases this cannot be done and the lengthening can be made at upper epiphyseal level. The technique involves the application of pins in the upper epiphysis and diaphysis fixed by a Hoffman external fixator adapted for progressive distraction. The technique was used in a child of 13 years with 9 cm of shortening and an expected shortening of 13 cm at the end growth. The method has obtained the progressive lengthening of 11 cm and bony union without grafting.