Objective: To introduce a new surgical approach to rectify the shortened lower limbs.
Methods: From March 1985 to October 2000, 288 cases of shortened lower limbs were treated and reviewed. Closed fracture at the metaphysis was made by a self-made "needle saw", and then the "multiple-plane and double-track elongation instrument" was adopted to elongate the fractured bone. There were totally 161 cases of male and 127 cases of female included, with average age 21.3 years old, ranging from 12 to 29 years old, among which there were 268 cases elongated at the proximal metaphysis of the tibia, 16 cases at the distal femur and 4 cases at the distal tibia. All of the cases were followed up for 6 to 8 months before clinical evaluation.
Results: The lower limbs in 288 cases were elongated for 3.0 to 11.5 cm in 24 to 96 days, averaging 47 days, which fulfilled pre-operative plan. In the second week after the operation, new calculus and periosteum formed obviously in the gap between the fractured parts, and in 6 to 8 months bone union was observed at the fractured site in all cases. There was no nerve or blood vessel injury, or non-union of the metaphysis fracture. The function of the manipulated knee joints and ankle joints recovered well.
Conclusion: It is a practical and safe surgical option to rectify the shortened lower limbs by closed fracture at the metaphysis, followed by elongation of the fractured bone, without any complication such as non-union or atrophy of manipulated bone, and with no need of internal fixation or bone grafting.