Lengthening of short femurs, including those with actual or anticipated shortening of several inches, has been carried out using serial lengthenings. Up to 5 individual lengthenings, each of approximately one inch, have been performed on involved femurs. In cases where shortening was due to epiphyseal injury, e.g. osteomyelitis of the distal femur, good results have been achieved. Congenital shortening has not been completely corrected because of subluxation of the hip during lengthening. The principle complication has been fracture through the plate and graft. Usually this fracture could be used as the indication for additional lengthening, thus minimizing the problem. It is believed that this approach offers advantages in terms of decreased total cost in time and money, making it suitable for private patients. An additional advantage is the lack of disastrous complications. Technical problems have been numerous, however. The procedure should not be undertaken casually or for minor leg length inequality.