Closed femoral shortening

Eighteen patients underwent closed intramedullary femoral shortening at a children's teaching hospital. Their average age was 16 years 2 months (range 14-18 years). Clinical and radiographic union was obtained in < or = 3 months in all patients. Shortening averaged 4.4 cm (range 3-5 cm). Complications included one case of acute respiratory distress and three cases of fixation loss. We describe the procedure for closed intramedullary rodding without use of a fracture table and recommend (a) that reaming proceed slowly through an enlarged proximal portal, and (b) that in all cases nails be interlocked both proximally and distally.