Limb Lengthening Library

Femur vs Tibia Lengthening

Anatomical comparison of the two primary lengthening sites
Femur (Thigh Bone)

Femoral Lengthening

Proposed amountAnatomy- and goal-specific
Osteotomy levelChosen for the operative plan
LoadingImplant- and plan-specific
Motion focusHip and knee trend
Soft tissueQuadriceps and hamstrings
ProgressImaging, function, and examination
Human leg bones — Femur, Patella, Tibia, Fibula
Knee Joint
Osteotomy
↕ Planned segment
Osteotomy
↕ Planned segment
⚠ Peroneal
nerve
Tibia (Shin Bone)

Tibial Lengthening

Proposed amountAnatomy- and goal-specific
Osteotomy levelChosen for the operative plan
LoadingImplant- and plan-specific
Motion focusKnee and ankle trend
Neurovascular focusPeroneal nerve and compartments
ProgressImaging, function, and examination
CategoryFemurTibia
Fixation optionsAntegrade or retrograde nails; external or hybrid methods in selected casesInternal, external, or hybrid methods depending on anatomy and indication
Adjacent jointsHip and kneeKnee and ankle
Soft-tissue monitoringQuadriceps, hamstrings, hip flexors, and nervesCalf structures, ankle motion, compartments, and nerves
Lengthening amountThere is no universal safe number. Proportions, bone size, soft tissues, joint motion, regenerate, symptoms, goals, and stopping rules all matter.
Sequential segmentsTreating both segments adds cumulative operations, rehabilitation, exposure time, and risk; sequence and candidacy require individualized assessment.
Anatomical illustration: Mariana Ruiz Villarreal (LadyofHats), Wikimedia Commons, Public Domain. Modified with surgical annotations.
Comparison reflects anatomical and planning differences, not a recommendation for one segment or method.
Educational reference only. Not medical advice. Device status, treatment parameters, and emergency instructions must be confirmed with current official sources and the treating team.