Tibial Lengthening: Technique for speedy lengthening by external fixation and secondary internal fixation

Chi Chuan Wu*, Wen Jer Chen

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

21 Scopus citations


Background:The conventional Ilizarov technique for tibial lengthening is frequently time-consuming, causes suffering, and is associated with many complications. This study takes a retrospective approach to investigate the outcome of applying a slightly speedier procedure using an Ilizarov apparatus and secondary internal fixation.Methods:Twelve adult patients displaying tibial shortening (median, 4.0 cm; mean, 4.6 cm; range, 3.0-12.0 cm) with various causes were treated with or without tibial osteotomy and stabilized using an Ilizarov lengthening apparatus. Postoperatively, lengthening of 1 to 1.5 mm/day was performed until the desired length was achieved. External fixation was then converted to internal fixation and either pure autogenous bone graft, or a mixture of autogenous and allogenous bone graft was supplemented. Postoperatively, protected weight bearing was advised until bony union was achieved.Results:Eleven patients were followed up for a median of 3.4 years (mean, 4.0 years; range, 2.1-6.7 years) and solid union was achieved in all cases. Median external fixation occurred after 1.8 months (mean, 1.9 months; range, 1.2-4.5 months) and the median time until union after internal fixation was 4.5 months (mean, 4.8 months; range, 4-6 months). Two patients with rigid equinus feet required concomitant Achillis tendon lengthening. No other significant complications were noted. Classification of the results revealed that improvement from an unsatisfactory to a satisfactory outcome was achieved in all patients (p < 0.001).Conclusion:The described technique shortens the external fixation period and reduces patient suffering. Moreover, a high union rate and a low complication rate are achieved. Subjectively and objectively, patients can achieve satisfactory outcomes. Consequently, the described technique may be considered as an alternative to conventional techniques when indicated.

Original languageEnglish
Pages (from-to)1159-1165
Number of pages7
JournalJournal of Trauma - Injury, Infection and Critical Care
Issue number6
StatePublished - 06 2003
Externally publishedYes


  • External fixation
  • Internal fixation
  • Tibial lengthening


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