One stage femoral lengthening in the adult.

One stage femoral lengthening procedures were performed in 9 adult patients. Eight patients had femoral shortening secondary to femoral fractures. The remaining patient had diffuse left hemiatrophy. The method of one stage lengthening has been modified from that described by Cauchoix. There were 7 males and 2 females with an average age of 23 years. The preoperative femoral shortening averaged 4.5 cm. The average lengthening at surgery measured 4.0 cm and 3.8 cm of this was maintained at follow-up. Complications included one case of serious sciatic and femoral nerve palsy, implant failure in 3 patients, a case of late femoral refracture following plate removal, and a case of acute femoral artery occlusion. There were no postoperative infections. Two cases required additional bone grafting of the osteotomy sites. There was no loss of preoperative hip or knee motion with this technique. One stage femoral lengthening by the method described is a major operative undertaking with several potential complications. The surgical technique is demanding and monitoring of the neurovascular status of the extremity during lengthening is mandatory. When properly executed, results are gratifying.