Hybrid Techniques for Limb Length and Deformity Correction

Distraction osteogenesis allows for the creation of new bone by creating a low energy “corticotomy” and slowly separating osseous segments. However, prolonged treatment with an external fixator can be difficult for the patient and surgeon, and has a unique complication profile with a steep learning curve. Herein, several methods are described by which Ilizarov’s classical principles have been preserved but treatment time has been shortened. After the latency and lengthening phases, the consolidation phase can see the removal of the frame. This is made possible by the addition of adjunctive fixation to preserve the corrected segment in its new alignment. Together, these adjuncts and traditional methods can be termed “hybrid” techniques of limb lengthening and deformity correction. The limb lengthening and deformity surgeon can deploy these techniques to maximum effect for the betterment of patient care by becoming facile with external fixation, internal fixation, and intramedullary implants.