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CASE REPORT

UCSF Benioff Children’s Hospital

Institute for Global Orthopaedics and Traumatology

Post-Traumatic Limb Deformities in Children and Young Adults: A Global Perspective 2025

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(P: 214634) Now that the patient presents at age 14 with a procurvatum deformity and LLD of 5.9 cm (Figure G, H, I, J K), if you choose to correct deformity + lengthen short side, would you do it in a single procedure or staged procedure?

I would not choose to correct deformity + lengthen short side

1%

3/216

Single procedure

44%

96/216

Staged - Correct deformity 1st, then length short side at later date

46%

101/216

Staged - 1st lengthen short side, then correct deformity at later date

5%

11/216

Outside my area of expertise - best if I don't vote

2%

5/216

Jan Szatkowski, MD, MBA perfectly done. Lengthening of the femur in this case is best achieved with antegrade nail and diaphyseal osteotomy, distraction phase 1 mm a day. Ilisarov is also an option

Well,it’s a extreme discrepancy paired with deformity Probably I’d get length 1st over a nail and secondarily angular correction

Great case... and outcome! Great learning points. If performing surgeries in children and adults, one should try not to stage. But in the case here presented, I would have also done a staged approach.

I’m curious as a non limb recon surgeon: once you’ve chosen to use a frame to address the distal femoral deformity, why not continue to lengthen through that osteotomy with the frame? Is this to shorten the period in a frame for the patient or are there other technical issues?