One of the first pioneers of leg lengthening was Alesandro Codivilla who, in 1903, performed femoral osteotomies in patients with coxa vara by applying traction via a cast and a transcalcaneal wire [
1]. About 10 years later, Louis Ombrédanne was the first to recognise the importance of a gradual lengthening and successfully performed a 4-cm femoral lengthening of 5 mm/day using an external fixator [
2]. Another 10 years later, August Bier published his technique of delaying lengthening after the osteotomy [
3]. The first ring fixator was introduced in the early 1950s by Wittmoser, but no attention was paid by his colleagues at that time [
4]. The main breakthrough came with the observations of Gavril Ilizarov (1921–1992), a general practitioner in Kurgan (southwest Siberia, Russia) who treated countless numbers of war veterans for posttraumatic deformities, infected pseudarthroses, and bony defects [
5]. He defined the main principles of leg lengthening and deformity correction such as the importance of a percutaneous corticotomy, a latency period of some days, a semi-rigid fixation and a defined distraction distance of 1 mm/day, which are still valid until today [
5]. Although Ilizarov published his findings already in 1969, his techniques firstly attracted real attention about 12 years later, when he healed the long-standing pseudarthrosis of a well-known Italian journalist named Carlo Mauri [
6,
7]. In the same year (1981), Ilizarov was invited to present his work at an AO infection conference in Lecco (Italy), initiating regular exchanges between Ilizarov and surgeons from the western world [
7].
Another fundamental step was the introduction of intramedullary lengthening devices in the 1970s. The first systems, such as the hydraulic pressure-driven lengthening nail by Götz et al., were open-source systems with external components being directly linked to the nail and, therefore, having high failure rates due to deep infections [
5,
8]. This handicap was overcome by fully implantable lengthening nails, the first being described in 1978 by Witt et al. [
9]. Bliskunov developed a mechanically driven lengthening nail with a ratchet mechanism, in which length was generated via a hip movement-mediated compression of the nail clicker at the iliac wing [
5]. In the last decade, especially two mechanical lengthening nails, namely, the Albizzia
® and the ISKD
® (Intramedullary Skeletal Kinetic Distractor), as well as the fully implantable motorised lengthening nail (Fitbone
®), have been used consistently and described in the literature [
10‐
12]. The latest developments of fully implantable lengthening nails are magnetically driven implants, namely, the Precice
® nail and the Phenix
® nail [
13,
14].