Experience with the Orthofix device for limb lengthening.

The DeBastiani technique is recommended for lengthenings in children and adolescents. The Orthofix device may also be employed for immediate correction of angular and rotational deformities followed by lengthening in pediatric patients. Caution is advised when employing this method in other patients. Lengthening should be avoided through areas of previously damaged or osteoporotic bone. This is especially true in adult patients who have exhibited less than optimal osteogenesis even in the best conditions. Bilevel lengthening or early internal fixation should be considered in adult patients when using this method. Bone formation attained with the DeBastiani method in achondroplastic patients has been encouraging. However, lengthening in achondroplastic patients is rarely indicated owing to the limitation of absolute height gained and the relative complication rate. DeBastiani's callotasis method of lengthening utilizing the Orthofix device offers several advantages when compared with the Wagner and Ilizarov methods. The Orthofix device is a versatile lengthener that offers the best overall biomechanical stability and the capability for dynamization. The application is relatively simple and requires less operative time than that of the circular frames. There is less risk of neurovascular injury with the use of half-pins, and radiographic evaluation is simplified. Bone formation with the Orthofix equals that attained with the Ilizarov device and has significantly diminished the need for bone grafting and internal fixation frequently required using the Wagner method. In children and adolescents, the total number of anesthetics required is reduced using the DeBastiani method owing to a lower complication rate and office pin removal.