Consent in Limb Lengthening Surgery: Predicting the True Incidence of Material Risk

Area of Science:

• Orthopedic surgery
• Limb reconstruction
• Surgical outcomes

Background:

• Informed consent requires understanding potential surgical risks.
• Limb lengthening procedures carry inherent complexities and potential complications.
• Accurate data on complication rates is crucial for patient counseling.

Purpose of the Study:

• To determine the published complication rates for lower limb lengthening.
• To provide data for surgeon-patient consultations regarding material risks.
• To enable auditing of surgical results against existing literature.

Main Methods:

• Literature review of PubMed and Google Scholar (2003-2023).
• Included studies on femur/tibia lengthening using external fixators or intramedullary nails (≥20 patients).
• Classified complications using Paley's framework.

Main Results:

• Twenty-two studies met inclusion criteria.
• External fixator complications: pin site infections (femur 52%, tibia 18.8%), delayed consolidation (8.3%), re-fracture (13%), joint stiffness (18.8%).
• Intramedullary nail complications: implant issues (8%), delayed consolidation (6%).

Conclusions:

• Lower limb lengthening involves significant potential complications.
• Published complication rates provide essential information for informed consent.
• Data aids surgeons in discussing risks and auditing practice.