Powell Kenneth P, Hammouda Ahmed I, Hlukha Larysa P, Rivera Jessica C, Patel Minoo, Rozbruch S Robert, Conway Janet D, Herzenberg John E
Shriners Hospital for Children, Shreverport, LA 71103, USA.
Department of Orthopedics and Trauma, Al-Azhar University Hospitals, Cairo 11511, Egypt.
J Clin Med. 2022 Sep 5;11(17):5242. doi: 10.3390/jcm11175242.
Limb lengthening has not been widely employed in the elderly population due to concerns that outcomes will be inferior. The purpose of this multicenter, retrospective case-control series was to report the bone healing outcomes and complications of lower limb lengthening in older patients (≥60 years) using magnetic intramedullary lengthening nail (MILN). Our hypothesis was that healing parameters including consolidation days, the consolidation index, maturation days, and the maturation index, as well as the number of adverse events reported in the older population, would be no different to those of the general adult population. We retrospectively reviewed charts and radiographs from patients ≥60 years of age with limb-length discrepancies who underwent femoral or tibial lengthening using a MILN. Parameters were compared among the age categories "≤19 years," "20-39 years," "40-59 years," or "≥60 years" and propensity-matched cohorts for the age groups 20-59 years and ≥60 years. Complications were reported as percentages for each age category. In the study period, 354 MILN were placed in 257 patients. Sixteen nails were placed in patients 60 years of age or older (mean 65 ± 5 years; range 60-72 years). Comparisons of healing parameters showed no difference between those aged 60+ and the younger cohort. Complication percentages were not statistically significant ( = 0.816). Limb lengthening with MILN may therefore be considered a safe and feasible option for a generally healthy elderly population.
由于担心效果不佳,肢体延长术在老年人群中尚未得到广泛应用。本多中心回顾性病例对照系列研究的目的是报告使用磁性髓内延长钉(MILN)对老年患者(≥60岁)进行下肢延长的骨愈合结果及并发症。我们的假设是,包括愈合天数、愈合指数、成熟天数和成熟指数在内的愈合参数,以及老年人群中报告的不良事件数量,与一般成年人群无异。我们回顾性分析了年龄≥60岁、存在肢体长度差异且接受股骨或胫骨MILN延长术患者的病历和X光片。对“≤19岁”“20 - 39岁”“40 - 59岁”或“≥60岁”各年龄组以及20 - 59岁和≥60岁年龄组倾向匹配队列的参数进行了比较。并发症以各年龄组的百分比形式报告。在研究期间,257例患者共置入354枚MILN。16枚钉子置入60岁及以上患者体内(平均65±5岁;范围60 - 72岁)。愈合参数比较显示,60岁及以上患者与较年轻队列之间无差异。并发症百分比无统计学意义(P = 0.816)。因此,对于总体健康的老年人群,使用MILN进行肢体延长术可被视为一种安全可行的选择。