Twenty-two skeletal lengthenings were performed on eight patients with congenital or traumatic brachydactyly between February 1983 and June 1987. There were nine metacarpal, nine metatarsal and four proximal phalangeal lengthenings. Two different methods have been used for lengthening : single stage lengthening by intercalary bone graft (19 procedures) and two stage distraction lengthening using external fixator (3 procedures). The mean follow up was 1.7 years. The mean lengthening acheived with single stage lengthening was 12.7mm and the mean overall lengthening was 13.1mm. The mean duration of fixation was 7.8 weeks in single stage lengthening and 15.3 weeks in two stage lengthening. Single stage lengthening is thought to be desirable, because it is simple and more lengthening can be acheived by double level lengthening.