A and B, Immediate postoperative anteroposterior and lateral radiographs demonstrating tibial lengthening over an intramedullary nail. C, After gradual lengthening, two distal interlocking screws and one distal tibiofibular transfixing screw are inserted. The external fixator is removed. (From Park HW, et al: Tibial lengthening over an intramedullary nail with use of the Ilizarov external fixator for idiopathic short stature, J Bone Joint Surg 90:1970–1978, 2008.) SEE TECHNIQUE 32.24.