Acute Shortening and Re-lengthening to Bridge Bone Defects

Combined bone and soft tissue loss of the leg is a challenging orthopedic problem due to paucity of soft tissue mass and the frequent need for staged reconstruction. Bone transport, as described by Ilizarov, has been successful in the management of such cases; however, the difficulties and problems encountered during bone transport made it a tedious work for both the surgeon and the patient. Acute limb shortening and re-lengthening (ASRL) was described to avoid the problems met with during bone transport. However, ASRL has its limits based on the size of soft tissue defect and the vascularity of the limb. Careful attention to the details of the technique is necessary to avoid acute ischemia of the limb. Overzealous acute shortening can be dangerous.