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Femoral Lengthening in Children-A Comparison Between Magnetic Intramedullary Lengthening Nails and External Fixators
Mohamed Hafez1,2, Nicolas Nicolaou1,2, Amaka Offiah1,3
1Department of Oncology and Metabolism, Medical School, Sheffield University.
Insights
PRECICE magnetic lengthening nails offer better outcomes for pediatric femoral lengthening compared to external fixators. These nails provide more accurate length achievement, a lower healing index, and fewer complications, improving patient recovery.
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.
Background:
Femoral lengthening can be achieved using external fixators or intramedullary lengthening nails. The purpose of this research was to compare the outcome of femoral lengthening in children using PRECICE magnetic lengthening nails with lengthening external fixators.
Methods:
Retrospective analysis of 50 children who had femoral lengthening. Group A included patients who had lengthening with external fixation, patients in Group B had lengthening with PRECICE intramedullary lengthening nails. Each group included 25 patients. The sample strictly included children aged between 11 and 17 years. Patients in each group were matched according to age and indication for lengthening whether congenital or acquired conditions. The outcomes focused on the ability to achieve target length, healing index, residual malalignment, length of hospitalization following the osteotomy surgery, and encountered complications.
Results:
Mean patient age was 14.7 years for each group. The length gain was 42±12 mm for Group A and 41.6±8 mm for Group B (P=0.84). Lengthening nails achieved the target length more accurately compared with external fixation (P=0.017). The healing index was significantly higher in group A with 53.2±19 days/cm compared with 40.2±14 days/cm in group B (P=0.03). Group A had significantly higher complications than group B (P<0.0001). There was no statistically significant difference in the final coronal malalignment between the 2 groups (P=0.2). The mean length of stay was 9.2±5.8 days for group A and 4.2±3.3 days for group B (P=0.0005).
Conclusion:
Magnetic lengthening nails are clinically effective for femoral lengthening in the pediatric population. Compared with external fixation, healing index and complications were more favorable with PRECICE nails. Further research is required to study the cost-effectiveness of this technique.
Level Of Evidence:
Level IV-case series.
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