Results of tibial lengthening with the Ilizarov technique.

Between June 1987 and June 1992, 62 tibiae in 52 patients underwent lengthening by using the Ilizarov technique. Follow-up was from 18 months to 5 years. The mean age at surgery was 12.9 years (range, 5-19). The etiology of limb shortening was congenital in 53 and acquired in nine tibiae. Thirty-five tibiae had bifocal and 27 had unifocal treatment. Twenty-two of the 62 limbs had simultaneous treatment of other associated problems, including rotational or angular deformity or foot deformity. The average lengthening was 7.5 cm (range, 3.5-12), which was equivalent to a 32% average overall increase in limb-segment length (range, 6-96%). Complications required 28 (22%) unplanned procedures in the 62 tibiae, including nine osteotomies for iatrogenic malunion or deformation of regenerate bone (31%). Three tendo Achilles lengthenings and posterior ankle capsulotomies were required for persistent equinus contractures. Bony complications declined as experience with the technique increased. This technique allows simultaneous lengthening correction with control of the adjacent foot when required.