Pediatric Orthopedics, Deformity Reconstruction and Foot Surgery, Muenster University Hospital, Muenster, Germany; General Orthopedics and Tumor Orthopedics, Muenster University Hospital, Muenster, Germany.
General Orthopedics and Tumor Orthopedics, Muenster University Hospital, Muenster, Germany.
Acta Orthop. 2024 Jan 30;95:47-54. doi: 10.2340/17453674.2024.35226.
Bilateral femoral distraction osteogenesis in patients with achondroplasia is insufficiently reported. We aimed to perform the first study that exclusively analyzed simultaneous bilateral femoral distraction osteogenesis with motorized intramedullary lengthening nails via an antegrade approach in patients with achondroplasia focused on reliability, accuracy, precision, and the evolving complications.
In this retrospective singlecenter study we analyzed patients with achondroplasia who underwent simultaneous bilateral femoral lengthening with antegrade intramedullary lengthening nails between October 2014 and April 2019. 15 patients (30 femoral segments) of median age 14 years (interquartile range [IQR] 12-15) were available for analysis. The median follow-up was 29 months (IQR 27-37) after nail implantation.
The median distraction length per segment was 49 mm (IQR 47-51) with a median distraction index of 1.0 mm/day (IQR 0.9-1.0), and a median consolidation index of 20 days/cm (IQR 17-23). Reliability of the lengthening nails was 97% and their calculated accuracy and precision were 96% and 95%, respectively. The most common complication was temporary restriction of knee range of motion during distraction in 10 of 30 of the lengthened segments. 1 patient was treated with 2 unplanned additional surgeries due to premature consolidation.
The method is reliable and accurate with few complications.
成骨不全症患者的双侧股骨延长术报道较少。我们旨在进行首例研究，通过经皮顺行髓内延长钉对成骨不全症患者行双侧股骨同时延长，重点关注其可靠性、准确性、精密度和不断出现的并发症。
本回顾性单中心研究纳入了 2014 年 10 月至 2019 年 4 月期间接受经皮顺行髓内延长钉双侧股骨延长术的成骨不全症患者。共纳入 15 例患者（30 个股骨段），平均年龄为 14 岁（四分位距 [IQR] 12-15）。在植入延长钉后中位随访 29 个月（IQR 27-37）。
每个节段的平均延长长度为 49mm（IQR 47-51），平均延长指数为 1.0mm/d（IQR 0.9-1.0），平均骨痂形成指数为 20d/cm（IQR 17-23）。延长钉的可靠性为 97%，计算出的准确性和精密度分别为 96%和 95%。最常见的并发症是 30 个延长段中的 10 个在延长过程中出现膝关节活动范围暂时受限。1 例患者因过早骨痂形成而接受了 2 次计划外的附加手术。
该方法可靠且准确，并发症较少。
