Treatment of femoral shortness due to nonunion or malunion by distraction device and Huckstep instrumentation.

Eighteen adult patients with nonunion or malunion of the femur and leg length discrepancy were treated with Wagner's distraction device and Huckstep instrumentation in one or two-staged operations. The Huckstep nail is introduced into the medullary cavity. Screws are transfixed to one segment before distraction. After completion of distraction, screws are transfixed to the other segment. Autogenous bone graft or allograft is also transfixed to fill up the gap. Continuous passive motion of the knee is conducted between operations and after operation. Postoperative protection is not necessary. All 12 patients who were operated for more than nine months had united and are reported here. Both patients with previous infection of the bone had flare up of the infection which was controlled medically. Both healed and united finally. No patient had contracture of the knee. This method corrects deformity and prevents angulation during distraction. Postoperative care is simple. The patient can return to his work soon after he is discharged. This method is not recommended for infection, bone of small caliber and desired lengthening for more than 6 centimeters.