A 3-month-old baby was initially referred to our hospital, on October 2007, for evaluation of the right side clubfoot that was treated in another hospital, with serial casting (). He was the first child of apparently healthy and young parents, after a normal 36 weeks pregnancy. He had normal motor development; there were no other deformities. He had a stiff right side clubfoot, with apparent shortening of the leg. He had a short 1st ray of the foot. Radiological examination confirmed the diagnosis of the distal tibiofibular diastasis. His parents went abroad to North Europe, where initial treatment was provided with serial casting and closed tenotomy of the Achilles tendon, improving the shape and the position of the foot. At the age of 18 months, he was brought for a new clinical and radiological evaluation. There was still a stiff equinus and varus position of the foot and LLD. X-ray examination showed the diastasis of the distal tibiofibular joint, with the talus intervening. There was shortening of the tibia (). The child was surgically treated at 4 years of age, in the same hospital abroad, where a distal tibiofibular synostosis and arthrodesis of the ankle joint were performed. The metalwork was removed 3 years later and an attempt to correct the valgus position of the knee was done with a plate at the medial growth plate of the distal femur (). The child returned to our hospital 8 years later, on February 2016, for another evaluation. He had completely stiff foot in varus and equinus, (30 d varus and 20d equinus), with a severe shortening of the limb. He was an apparently healthy boy, attending school, but stayed always indoors. He moved around with crutches. Several attempts were made to wear a modified shoe, with appropriate shoe raiser, on the right leg, but it was unsuccessful. The child was in severe emotional stress, as he could not participate in most of the daily activities for his age. His new X-ray examination revealed the equinus and varus position of the foot. A scanogram estimated the LLD at 6,5 cm for the tibia (). After a thorough discussion with the parents, we corrected the limb in two stages. First (February 24, 2016), we applied an Ilizarov frame and performed an osteotomy at the distal tibial and proceeded in a gradual opening of the osteotomy, simultaneously correcting the varus and equinus position of the foot. We achieved a full correction of the position of the foot, using appropriate hinges, and new bone developed in the widening of the osteotomy (). After consolidation of the osteotomy, on April 19, 2016, we performed an osteotomy at the proximal tibia and fibula and started lengthening the limb. We were following our patient every 10 days with an X-ray AP and lateral of the tibia. He was walking around with crutches with partial weight-bearing as tolerated. His mother was regularly cleaning the pin sites and she was performing the lengthening with a rate of 1 mm in 4 daily intervals. No major complications were encountered. The boy and his family were very cooperative. We achieved 4,5 cm lengthening, with a nice regenerate of the tibia. This was our schedule, not to exceed 20% of the initial length of the tibia. The apparatus was removed on July 22 and we applied a functional ankle orthosis for the mobility of the child. The frame remained for 5 months in total. The boy started walking with crutches with gradual weight-bearing, with the orthosis (). We achieved a stable plantigrade foot, with 2 cm discrepancy. Our patient was very functional and extremely happy about the final result. We applied a normal shoe, with a shoe raise of 1.5cm that permitted him to participate in many daily activities, avoiding jumping. His latest follow-up, 1 year after the frame removal, he is walking around using only the foot orthosis ( and ). We plan to equalize the leg discrepancy with another lengthening procedure, at his early adolescence. Using the multiplier method for predicting limb length discrepancy in a congenital condition, with permanent epiphysiodesis of the distal tibial physis of the short limb, we estimated that the final LLD will be 7 cm. The initial LLD of 2 cm at the age of 9.2 of the boy with current multiplier 1.36 predicts that A amount of growth remaining for the left tibia will be G=L(M-1) 26cm(1.36–1)=9.36cm B Amount of growth remaining for the epiphysiodesis right tibia will be G=L(M-1) × k that is calculated as 24cm(1.36–1) × 0.5=4.32cm The amount of estimated LLD will be 9.36–4.32=5 cm, adding the 2 cm of the existing LLD, equals a predicted LLD of 7 cm at maturity.