A circular external fixator is applied to the limb and the bone is cut in between. The bone cut is done through a small skin incision to preserve all the soft tissues around the bone. The bone is then distracted at approximately 1mm per day until the desired length is achieved. Once the length is achieved the consolidation phase starts where the bone has to heal before the external fixator can be removed.

Post-operative care

Immediately after surgery patients are generally permitted to put their full weight on their leg.

The dressings are changed in the hospital on post-operative day 2 or 3 and then kept until the first clinic visit.

One week after the surgery, the TSF struts need to start to be adjusted according to a schedule that you will be given by the doctor.


The struts on the TSF are number 1 to 6 and each strut has a small metal ball that sits next to a number.  The struts can be adjusted by turning the + towards the arrow and or away from the arrow to go up or down. (see section on how to adjust your struts).


For a complete list of the risks and complications, please see Patient info.

Patients who will undergo this procedure should read the following sections in the Patient information tab.

1- External fixator Immediate post-operative care

2- TSF adjustments

3- Pin site care and infection protocol