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Characterizing the Limb Lengthening Experience: Length of Stay and Readmission Rates Following Limb Lengthening
Michael D Greenstein1, Gerard A Sheridan, Brian Joseph Page
1From the University of Michigan Medical School, Ann Arbor, MI (Greenstein), the Department of Orthopaedics, University of Galway, Galway, Ireland (Sheridan), the Hospital for Special Surgery, Orthopaedic Trauma Service, New York, NY (Page), and the Hospital for Special Surgery, Limb Lengthening and Complex Reconstruction Service, New York, NY (Hoellwarth, Reif, Fragomen, Rozbruch).
Motorized internal lengthening nails (MILN) show a median length of stay (LOS) of 3 days, with 2 days being most common. Increasing age, ethnicity, and surgery day impact LOS, while age also influences readmission rates.
Area of Science:
- Orthopedic Surgery
- Biomedical Engineering
Background:
- Limb lengthening techniques have advanced from external fixation to motorized internal lengthening nails (MILN).
- Improved length of stay (LOS) and reduced readmission rates are anticipated with MILN adoption.
- This study characterizes LOS and readmission in a contemporary cohort using MILN.
Purpose of the Study:
- To describe the length of stay (LOS) in patients undergoing limb lengthening with MILN.
- To determine the readmission rates following limb lengthening procedures.
- To identify variables associated with LOS and readmission.
Main Methods:
- Retrospective cohort study of 213 limb lengthening events (October 2016 - June 2022).
- Analysis of patient demographics, surgical factors, LOS, and readmission data.
- Statistical methods included linear regression, Mann-Whitney U, Kruskal-Wallis, logistic regression, and Chi-square tests.
Main Results:
- Median LOS was 3 days; mode LOS was 2 days (41.8% of procedures).
- Increased LOS was associated with older age, patient ethnicity, and surgical day of the week.
- The readmission rate was 14.1%, with delayed union being the most common cause; increasing age was the only significant predictor of readmission.
Conclusions:
- Limb lengthening with MILN demonstrates a short median LOS of 3 days.
- Factors such as age, ethnicity, and surgical timing influence LOS, while age is a key factor for readmission.
- These findings provide valuable insights for patient counseling regarding the postoperative course.
