Bone lengthening techniques are indicated for the treatment of congenital agenesis or trauma-induced shortness of the foot. However, lengthening is not an appropriate choice of treatment for amputation stumps due to vascular disease or gangrene in diabetic patients.
For bone stumps due to agenesis, it is common for the extensor tendon insertions to be intact at various levels. In the case of posttraumatic bone stumps, however, these insertions may be injured or removed, so the kinetic balance of the extremity is compromised. The skin may also be compromised by shearing, these factors need to be taken into account when planning the osteotomy sites(s) and the correction.