Radiographic presentation of the same patient two years after lengthening procedure. Severe valgus deformity of 85° of the distal tibia in the age of nine y.o., and two years after completing a lengthening procedure of the tibia. Despite multiple efforts to correct axial malignment during lengthening this was not gained and a severe valgus deformity of the ankle with a prominent antero-medial bowing of the tibia were obvious. It is believed that a severe dysplasia of the lateral distal epiphysis of the tibia is mainly responsible for this resisting to treatment deformity.