In the first phase, called the "osteotomy/surgical phase", the bone is cut, either partially, only through the hard exterior, or completely, and a device is fitted which will be used in the next phases. In the second phase, the latency period, which lasts generally seven days, the appliance is not activated and early stages of bone healing are allowed. In the third phase, the<unk>  phase", the device, which is mounted to the bone on each side of the cut, is used to gradually separate the two pieces, allowing new bone to form in the gap. When the desired or possible length is reached, which usually takes three to seven days, a consolidation phase follows in which the device keeps the bone stable to allow the bone to fully heal. After the consolidation phase, the device is removed in a second surgical procedure. The device is usually manually operated by twisting a rod that separates the bone using a rack and pinion or similar system ; the rate of separation is carefully determined because going too quickly can cause nonunion, in which unstable fibrous connective tissue is formed instead of bone, and going too slowly can allow premature union to occur. Generally the rate is about a millimeter per day, achieved in two steps per day. The frequency of steps and how much the device is moved at each step, is called the "rhythm". The devices sometimes contain a spring that provides tension to continually separate the bones, instead of being manually operated at set intervals. In addition to these manually operated systems there are also motorized systems like the Fitbone from Wittenstein. The Fitbone is a fully implantable, motorized, lengthening and correction nail. Advantages of this device are accurate deformity correction, low scar tissue formation, and reduced risk of infection. Furthermore, the patients describe the procedure as more comfortable than limb lengthening with mechanical systems.
Distraction osteogenesis
Triple arthrodesis
Autologous chondrocyte implantation
Epiphysiodesis
Osteoplasty
High tibial osteotomy
Arthrodesis
Bone grafting