Treatment with external fixation in lower-limb deformities is quite effective, even in severe deformities, since the progressive distraction and/or rotation strongly reduce risks for soft tissues, nerves or arterial lesions.

We have employed the Ilizarov circular frame in 53 patients affected with multi-planar deformities and a uni-lateral fixator in 21 patients affected with angular deformities only from 1984 to 2000 in the Orthopaedic Clinic of the University and C.T.O. of Firenze and from 2001 up to the present in the Poggibonsi Hospital.

Multi-planar deformities include various associations of angulation also in different planes, rotational malalignment and length discrepancies in congenital, post-traumatic or neurological disorders.

A uni-lateral fixator was used mainly for varus tibia or valgus femur deformities in patients under 30 years of age for severe angular deviation following congenital, post traumatic or rickets pathologies.

The results obtained in our series were better, regarding both the treatment time and achieving the desired correction, for uni-planar deviations than for more complex deviations where shortening and rotational defects were combined. These cases require longer treatment time and show a 9% rate of fair results. We did not achieve poor results and bone consolidation was always seen at the follow-up.