Limb lengthening and correction of angulation deformity: immediate correction by using a unilateral fixator

We performed limb lengthening (callus distraction) with immediate correction of the angulation deformity in 11 patients (16 long-bone segments) in Chiba Children's Hospital. The operated segments were 14 tibias and two femurs. The average age at operation was 12.0 years (range, 4.8-15.3). All had varus deformities and limb shortening. We used the Orthofix unilateral fixator in all cases. The following two types of osteotomy were selected, depending on the degree of the varus deformity: opening wedge osteotomy if it was < 20 degrees or dome osteotomy if > 20 degrees. The average amounts of the leg lengthening and the correction angle were 32.4 mm (range, 20-50) and 23.8 degrees (range, 15-40 degrees). The average of the healing index was 32.6 days/cm (range, 28.5-36.8 days/cm). There was also no difference in healing index between the two osteotomies groups, despite the greater angular correction in the dome osteotomy group. We concluded that our method of lengthening with immediate correction of deformity was a very simple and effective method.