Twenty-five years' experience with lengthening of shortened lower extremities using cylindrical allografts.

In order to decrease the time for treatment in lengthening of limbs, a method has been developed for cortical allografting of the distraction gap. After distraction of a middiaphyseal subperiosteal osteotomy at 1-2 mm per day using a circular external fixator and with an unreamed flexible nail in place, the distraction gap is allografted using a tubular bone segment. In contrast to conventional tubular bone allografting, this graft is slotted. The open end is placed into the most vascular and osteogenic aspect of the bed. This was believed to lead to more rapid consolidation and incorporation of the graft by the host. While some complications occurred, the goals of treatment were achieved in most patients.