Department of Oncology and Metabolism, Medical School, Sheffield University.
Paediatric Limb Reconstruction Unit.
J Pediatr Orthop. 2022 Mar 1;42(3):e290-e294. doi: 10.1097/BPO.0000000000002039.
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.
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.
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).
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 IV-case series.
股骨延长可通过外固定器或髓内延长钉实现。本研究旨在比较使用 PRECICE 磁力延长钉和外固定器进行儿童股骨延长的结果。
回顾性分析 50 例接受股骨延长的儿童患者。A 组包括接受外固定器延长的患者，B 组包括接受 PRECICE 髓内延长钉延长的患者。每组各有 25 例患者。样本严格包括年龄在 11 至 17 岁之间的儿童。根据年龄和延长的适应证（先天性或后天性），每组患者进行匹配。研究结果集中在达到目标长度的能力、愈合指数、残余对线不良、截骨术后住院时间和并发症的发生情况。
两组患者的平均年龄均为 14.7 岁。A 组的长度增加为 42±12mm，B 组为 41.6±8mm（P=0.84）。与外固定器相比，延长钉更准确地达到目标长度（P=0.017）。A 组的愈合指数明显更高，为 53.2±19 天/cm，B 组为 40.2±14 天/cm（P=0.03）。A 组的并发症明显高于 B 组（P<0.0001）。两组最终冠状面对线不良无统计学差异（P=0.2）。A 组的平均住院时间为 9.2±5.8 天，B 组为 4.2±3.3 天（P=0.0005）。
磁力延长钉在儿童人群中行股骨延长是有效的。与外固定器相比，PRECICE 钉在愈合指数和并发症方面更具优势。需要进一步研究该技术的成本效益。
IV 级病例系列。
