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Trauma

OUTCOME OF FEMORAL LENGTHENING: A COMPARISON OF THE PRECICE INTRAMEDULLARY LENGTHENING NAIL AND THE LRS NAIL EXTERNAL FIXATOR LENGTHENING SYSTEM

British Limb Reconstruction Society (BLRS) AGM & Instructional Course



Abstract

Background:

External fixators are not as well tolerated around the femur when compared to the tibia. Lengthening with an intramedullary device is therefore attractive.

Method:

We reviewed all cases of femoral lengthening performed at our unit from 2007 to 2014. Cases of non-unions, concurrent deformities, congenital limb deficiencies and lengthening with an unstable hip were excluded. This left 33 cases for review. Healing index, implant tolerance and complications were compared.

Results and Discussion:

In 20 cases the Precice lengthening nail was used and in 13 cases 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 Precice group had a more rapid return to full weight bearing. The mean healing index was 31.3 days/cm in the Precice and 47.1 days/cm in the LRS group. There was an increased incidence of 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.

Conclusion:

We conclude excellent functional results with fewer complications and greater patient satisfaction in femoral lengthening with a Precice intramedullary nail.