Evaluation of simultaneous bilateral femoral distraction osteogenesis with antegrade intramedullary lengthening nails in achondroplasia with rhizomelic short stature: a retrospective study of 15 patients with a minimum follow-up of 2 years

Authors

  • Björn Vogt Pediatric Orthopedics, Deformity Reconstruction and Foot Surgery, Muenster University Hospital, Muenster, Germany; General Orthopedics and Tumor Orthopedics, Muenster University Hospital, Muenster, Germany https://orcid.org/0000-0002-8781-2751
  • Andrea Laufer Pediatric Orthopedics, Deformity Reconstruction and Foot Surgery, Muenster University Hospital, Muenster, Germany; General Orthopedics and Tumor Orthopedics, Muenster University Hospital, Muenster, Germany https://orcid.org/0000-0001-5658-2298
  • Georg Gosheger General Orthopedics and Tumor Orthopedics, Muenster University Hospital, Muenster, Germany
  • Gregor Toporowski Pediatric Orthopedics, Deformity Reconstruction and Foot Surgery, Muenster University Hospital, Muenster, Germany; General Orthopedics and Tumor Orthopedics, Muenster University Hospital, Muenster, Germany
  • Carina Antfang Pediatric Orthopedics, Deformity Reconstruction and Foot Surgery, Muenster University Hospital, Muenster, Germany; General Orthopedics and Tumor Orthopedics, Muenster University Hospital, Muenster, Germany
  • Jan Duedal Rölfing Children’s Orthopedics and Reconstruction, Aarhus University Hospital, Aarhus, Denmark https://orcid.org/0000-0001-7934-2983
  • Robert Rödl Pediatric Orthopedics, Deformity Reconstruction and Foot Surgery, Muenster University Hospital, Muenster, Germany; General Orthopedics and Tumor Orthopedics, Muenster University Hospital, Muenster, Germany https://orcid.org/0000-0002-1731-6293
  • Adrien Frommer Pediatric Orthopedics, Deformity Reconstruction and Foot Surgery, Muenster University Hospital, Muenster, Germany; General Orthopedics and Tumor Orthopedics, Muenster University Hospital, Muenster, Germany

DOI:

https://doi.org/10.2340/17453674.2024.35226

Keywords:

Achondroplasia, Bone, Disproportionate short stature, Distraction osteogenesis, Genetic disorders, Implants

Abstract

Background and purpose: 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.
Patients and methods: 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.
Results: 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.
Conclusion: The method is reliable and accurate with few complications.

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Published

2024-01-30

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Vogt, B., Laufer, A., Gosheger, G., Toporowski, G., Antfang, C., Rölfing, J. D., … Frommer, A. (2024). Evaluation of simultaneous bilateral femoral distraction osteogenesis with antegrade intramedullary lengthening nails in achondroplasia with rhizomelic short stature: a retrospective study of 15 patients with a minimum follow-up of 2 years. Acta Orthopaedica, 95, 47–54. https://doi.org/10.2340/17453674.2024.35226

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Vol. 95 (2024): Acta Orthopaedica

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Copyright (c) 2024 Björn Vogt, Andrea Laufer, Georg Gosheger, Gregor Toporowski, Carina Antfang, Jan Duedal Rölfing, Robert Rödl, Adrien Frommer

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Acta Orthopaedica (Scandinavica) content is available freely online as from volume 1, 1930. The journal owner owns the copyright for all material published until volume 80, 2009. As of June 2009, the journal has however been published fully Open Access, meaning the authors retain copyright to their work. As of June 2009, articles have been published under CC-BY-NC or CC-BY licenses, unless otherwise specified.
 
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