Femoral lengthening in patients having abnormal ipsilateral hip or knee

Femoral lengthening using the Wagner technique was performed for 13 patients with abnormal adjacent joints. An average of 6.3 cm (19.5%) of lengthening was achieved. Three patients had no difficulties during lengthening. Transient non-surgical problems identified were blood pressure elevation, nerve palsy, and psychiatric reactions. Significant obstructions or complications occurred 13 times in nine cases. These included contractures of ipsilateral joints, angulations of the lengthened femur, Wagner device slippage, nonunion, and late hip subluxation. Other authors have reported similar difficulties in patients with normal ipsilateral joints. In this series, the advantage of achieving greater length appeared to outweigh the complications.