Research summary
A large multicenter study tracking 314 internal lengthening nails in 257 patients found that 53% experienced at least one complication. Key risk factors included age over 30, tibial lengthening, and short stature as the underlying condition.
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]
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 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.
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.
Informational only. Not medical advice.