Clinical presentation of the same patient in the age of thirteen years old. Four years after completion of the second surgical procedure. Although there is an acceptable mechanical axis, there is a quite uncomfortable valgus deformity of the ankle. After two procedures, the overall length that was gained was only 3.0 cm in the cost of multiple previous efforts to correct axial malalignment in priority. Marked calf atrophy and a leg length discrepancy of 5.0 cm are clearly shown.