H49 OMB Groote Schuur Hospital, University of Cape Town, Cape Town, 7925, South Africa.
The Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, Middlesex, HA7 4LP, UK.
Bone Joint J. 2016 Oct;98-B(10):1382-1388. doi: 10.1302/0301-620X.98B10.36643.
Patients undergoing femoral lengthening by external fixation tolerate treatment less well when compared to tibial lengthening. Lengthening of the femur with an intramedullary device may have advantages.
We reviewed all cases of simple femoral lengthening performed at our unit from 2009 to 2014. Cases of nonunions, concurrent deformities, congenital limb deficiencies and lengthening with an unstable hip were excluded, leaving 33 cases (in 22 patients; 11 patients had bilateral procedures) for review. Healing index, implant tolerance and complications were compared.
In 20 cases (15 patients) the Precice lengthening nail was used and in 13 cases (seven patients) the LRS external fixator system. The desired length was achieved in all cases in the Precice group and in 12 of 13 cases in the LRS group. The mean healing index was 31.3 days/cm in the Precice and 47.1 days/cm in the LRS group (p < 0.001). This was associated with an earlier ability to bear full weight without aids in the Precice group. There were more complications with LRS lengthening, including pin site infections and regenerate deformity. Implant tolerance and the patients' perception of the cosmetic result were better with the Precice treatment.
Femoral lengthening with the Precice femoral nail achieved excellent functional results with fewer complications and greater patient satisfaction when compared with the LRS system in our patients. Cite this article: Bone Joint J 2016;98-B:1382-8.
与胫骨延长相比，接受外固定股骨延长的患者治疗效果较差。髓内装置进行股骨延长可能具有优势。
我们回顾了 2009 年至 2014 年在我们单位进行的所有单纯股骨延长病例。排除骨不连、并发畸形、先天性肢体缺陷和髋关节不稳定的延长病例，留下 33 例（22 例患者；11 例患者双侧手术）进行回顾。比较愈合指数、植入物耐受性和并发症。
20 例（15 例）患者使用 Precice 延长钉，13 例（7 例）患者使用 LRS 外固定器系统。在 Precice 组所有病例均达到预期长度，在 LRS 组 13 例中的 12 例达到预期长度。Precice 组的平均愈合指数为 31.3 天/cm，LRS 组为 47.1 天/cm（p < 0.001）。这与 Precice 组更早能够在无辅助下完全负重有关。LRS 延长术的并发症更多，包括针道感染和再生畸形。植入物耐受性和患者对美容效果的感知在 Precice 治疗中更好。
与 LRS 系统相比，在我们的患者中，使用 Precice 股骨钉进行股骨延长可获得出色的功能结果，并发症更少，患者满意度更高。
Bone Joint J 2016;98-B:1382-8.
