Introduction and Aims: Patient presented with an equinovarus deformity of the left foot and ankle, and high above knee amputation of right leg. Femoral stump extended 6cm below lesser trochanter. Patient was wheelchair bound. Aim: Lengthening of stump, ensuring proper prosthesis fitment. Correction of left-side deformity, by means of calcaneal tibial fusion.

Method: A tibio-calcaneal fusion of ankle was performed, correcting equinovarus deformity. Patient fitted with orthotic boot with rocker bottom sole.

Corticotomy was performed below lesser trochanter and an Orthofix Limb Reconstruction System was used to lengthen stump. Lengthening started 10 days post-surgery. Five months later l0cm of length had been added. Fixator was left in situ. Six months later, the ex-fix was removed after consolidation of calus. Five months later patient had a new prosthesis fitted and a further five months later, patient was walking with prosthesis, and orthosis for the left ankle, assisted with one crutch.

Results: By July 2003, the patient was walking with a prosthesis and the length gain of the stump on the right was 10cm. The full length of the right femur was now 25cm, allowing a proper above knee prosthesis. The left ankle is fused in a functional position and completely pain free. Full weight-bearing is now possible, albeit with a rocker bottom sole.

Conclusion: Lengthening of a short femoral stump is a useful procedure to create a suitable stump for an above knee prosthesis, certainly if one considers that the alternative is an ischial weight-bearing caliper.