Fig. 1.

An 8-year-old girl with 4 cm congenital left femoral shortening (Pappas type IX). a Day 1 after diaphyseal drill hole osteotomy. Normal alignment, 50 % lateral translation. b 7.5 weeks after the index procedure, 6 weeks of distraction. Secondary 10° varus deformity. Timely callus formation and ossification. c Four months follow-up prior to hardware removal. Anteroposterior and slight oblique view to prevent bone–fixator overlap in order to provide a free projection of the femur. Three of four cortices are consolidated. Residual varus angulation, full restoration of length