Metaphyseal and physeal lengthening.

The potential problems associated with physeal distraction and the relative success of callus distraction favor callus distraction as the procedure of choice for equalization of major limb-length discrepancies. Indications for lengthening are the same as in the Wagner procedure. The expected results and soft-tissue complications of callus distraction are similar to those of the Wagner technique. However, the number of procedures required and the osseous complications of lengthening appear to be reduced with these newer methods of limb lengthening.