Distraction histogenesis continues to expand in the potential applications in the care of children. Research in basic science and biomechanics has been directed toward optimizing frame stability and regenerate for nation. Clinical applications have expanded from the areas of long bone lengthening into deformity correction in the foot and lengthening techniques in the hand, which allow increased function. In the field of long bone lengthening, comparisons of the Wagner technique with distraction histogenesis continue to show improved function after distraction histogenesis. In addition, the combination of internal and external fixation in distraction histogenesis in the hand and long bones has led to increased motion and bone stability. A resurgence of interest is also evident in the application of hemiepiphyseal stapling, not only to coronal plane deformities, but also to sagittal plane deformities. The application of lengthening techniques to short stature also continues to expand with increasing information about the benefits and complications associated with this group of patients.