Femoral Lengthening in Children-A Comparison Between Magnetic Intramedullary Lengthening Nails and External Fixators

Area of Science:

• Orthopedic surgery
• Pediatric orthopedics
• Biomechanical engineering

Background:

• Femoral lengthening is a critical procedure for addressing limb length discrepancies in children.
• Traditional methods include external fixators and intramedullary lengthening nails.
• PRECICE magnetic lengthening nails represent a modern advancement in this field.

Purpose of the Study:

• To compare the clinical effectiveness of PRECICE magnetic lengthening nails versus external fixators for femoral lengthening in pediatric patients.
• To evaluate key outcomes including accuracy of length achievement, healing index, malalignment, hospitalization duration, and complication rates.

Main Methods:

• A retrospective analysis of 50 pediatric patients (aged 11-17 years) undergoing femoral lengthening was conducted.
• Patients were divided into two matched groups: Group A (external fixation) and Group B (PRECICE nails), with 25 patients each.
• Outcomes assessed included target length achievement, healing index, residual malalignment, length of stay, and complications.

Main Results:

• Both methods achieved comparable length gains (approximately 41-42 mm).
• PRECICE nails demonstrated significantly greater accuracy in achieving target length (P=0.017) and a more favorable healing index (40.2 days/cm vs. 53.2 days/cm, P=0.03).
• Group B experienced significantly fewer complications (P<0.0001) and a shorter hospital stay (4.2 days vs. 9.2 days, P=0.0005) compared to Group A.

Conclusions:

• PRECICE magnetic lengthening nails are a clinically effective option for pediatric femoral lengthening.
• This technique offers advantages over external fixation, including improved healing rates and reduced complication incidence.
• Further investigation into the cost-effectiveness of PRECICE nails is warranted.