Gradual correction of bone deformity is considered in patients with a limb-length discrepancy and congenital deformity and is effective and safe. However, the long duration of external fixation is associated with many complications, including joint stiffness and pin tract infection. In addition, external fixation is associated with psychological stress on patients, especially children, and their family. Motorized nails are a good treatment option for lengthening and deformity correction but cannot be used in children and patients with small bones. They also are expensive to manufacture and use. Various techniques to shorten the duration of external fixation have described, including lengthening then nailing, lengthening over the nail, lengthening then plating, and lengthening over the plate. This video reviews some of the important tips and tricks associated with these four techniques to achieve safe and effective management of deformity via a combination of external and internal fixation.