To report the results of the intramedullary skeletal kinetic distractor (iskd) in patients with established leg length discrepancy following lower limb trauma.

12 patients with significant leg length discrepancy (> 20mm) following lower limb trauma were operated on using the iskd nail between september 2004 and december 2007. patients were followed up clinically and radiologically at minimum 18 months (mean: 27months range: 18–24 months).

8 femurs and 4 tibias were operated using the iskd nail. all patient in the series had successful completed treatements. the average leg length discrepancy was 38mm (91mm–21mm) and the average gained length was 37mm (76m–22mm). radiological union and bone consolidation were slow to occur. early weight bearing was permitted allowing earlier functional capacity. 6 patients required additional operations; 3 manipulation under anaesthesia for failed lengthening and 3 bone grafting for poor regenerate, 1 patient required more than one additional operation.

The iskd nail is an effective and reliable alternative technique for correcting leg length discrepancy in patients who have suffred lower limb trauma. it appears to mimic the results achieved with the use of a fine wire external fixator or a unilateral external fixator. the convenience of a fully implanted device is substantial. the complications are frequent but manageable with standard techniques.