Closed femoral diaphyseal shortening, as described by Winquist et al. (see text). A, Medullary canal is reamed with standard cannulated reamer. Special medullary saw is inserted into reamed canal. One or two rotations are made with saw at each setting, and saw is progressively opened until blade is completely exposed. B, After both saw cuts have been made, intercalary segment is split using back-cutting chisel. Rotational alignment and distraction can be controlled with locked medullary nail. SEE TECHNIQUE 29.43.