In brief
Who does the 53% complication figure in the 314-nail study describe?
The study reviewed 314 lengthened segments in 257 patients. In an analysis restricted to one randomly selected segment per patient, 53% had at least one complication under the study's classification. The mixed-indication cohort was mostly FITBONE and femoral procedures; it is not a cosmetic PRECICE-only risk estimate.
Limits: This summary explains evidence context and limitations; it is not medical advice.
- Evidence
- Peer-reviewed evidence
- Source set
- Peer-reviewed sources
- Updated
- References
- 1 listed
Editorial responsibility: Limb Lengthening Library editorial team. Independent medical review is not claimed unless a named reviewer is listed. How sources are reviewed.
Study Design
Frost and colleagues retrospectively reviewed 314 lower-limb lengthenings in 257 patients at two hospitals. FITBONE accounted for 75% of segments, PRECICE for 26% after rounding, and femoral procedures for 80%. Indications included congenital, acquired or developmental, short stature, and unknown categories. [1]
Main Findings
In a sub-cohort restricted to one randomly selected segment per patient, 53% had at least one complication under the study's classification. Device-related events were the most frequent origin category, followed by joint events. The adjusted model estimated a higher risk for tibial than femoral lengthening and for age groups above 30 compared with the 10-to-19 reference group.
The Per-Millimeter Result
The crude model estimated a relative risk of 1.01 per millimeter lengthened. After adjustment for age and etiology, the 95% confidence interval was 0.99 to 1.01. The authors stated that the adjusted analysis provided no evidence that amount lengthened increased complication risk in this dataset. The paper should not be converted into a 1%-per-millimeter calculator.
Limits on Generalization
- Retrospective records can miss or classify events differently.
- The cohort was not limited to adult cosmetic stature lengthening.
- Most implants were FITBONE and most segments were femoral.
- A center, implant, and patient-specific risk cannot be read directly from the cohort percentage.
Why the Study Is Valuable
The study used a predefined complication system, reported severity and origin, and highlighted how incomplete or inconsistent reporting can understate burden. Its best use is to improve consent questions and reporting standards, not to provide a single universal rate.
Sources
Verification policyInformational only. Not medical advice.