Complications after cosmetic limb lengthening, a specialized center experience

IF 1.5 Q3 ORTHOPEDICS Journal of orthopaedics Pub Date : 2024-09-11 DOI:10.1016/j.jor.2024.09.011
Akram Al Ramlawi, Daniel J. Over, Michael Assayag, Philip McClure
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Abstract

Background

Cosmetic limb lengthening has been rapidly growing ever since the advent of the external fixators magnetic lengthening nails. Similar to all surgical procedures, cosmetic limb lengthening is not risk free. This paper presents a series of complications encountered and treated at a specialized limb lengthening and deformity correction center, along with an analysis of potential risk factors.

Methods

A series of referred patients for complications after limb lengthening using IM nails were identified. Collected variables included demographics, place of index surgery, complication, and treatment of choice and outcome of treatment.

Results

22 limb lengthening procedures were identified. Most of these cases were done outside of the U.S. Hardware failure occurred in 23 % of index surgeries, primarily affecting femurs. Mal/nonunion rates were high (45 %), with femurs most affected. Iatrogenic deformities, primarily tibial, and soft tissue complications including contractures and nerve entrapment were observed. Treatment strategies included hardware exchange, bone grafting, and soft tissue release. All patients were successfully treated without any patients suffering from serious long term irreversible outcomes.

Conclusion

This study examines the surgical management of complications arising from cosmetic limb lengthening procedures at a single institution. We provide insights into effective treatment strategies and highlight the risks associated with medical tourism for these procedures. Our findings demonstrate a rising incidence of complications linked to international limb lengthening centers.

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美容肢体延长术后的并发症,专业中心的经验之谈
背景自从外固定器磁性延长钉问世以来,肢体美容延长术迅速发展。与所有外科手术类似,美容性肢体延长术也并非没有风险。本文介绍了在一家专门的肢体延长和畸形矫正中心遇到和治疗的一系列并发症,以及对潜在风险因素的分析。收集的变量包括人口统计学、手术地点、并发症、选择的治疗方法和治疗结果。这些病例大多是在美国以外的地方完成的。23%的索引手术出现了硬件故障,主要影响股骨。不良/不愈合率很高(45%),股骨受影响最大。还发现了先天性畸形(主要是胫骨)和软组织并发症(包括挛缩和神经卡压)。治疗策略包括硬件交换、植骨和软组织松解。所有患者都得到了成功治疗,没有任何患者出现长期不可逆转的严重后果。 结论:本研究探讨了一家医疗机构对美容性肢体延长术并发症的手术治疗。我们深入探讨了有效的治疗策略,并强调了与这些手术相关的医疗旅游风险。我们的研究结果表明,与国际肢体延长中心相关的并发症发生率正在上升。
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来源期刊
CiteScore
3.50
自引率
6.70%
发文量
202
审稿时长
56 days
期刊介绍: Journal of Orthopaedics aims to be a leading journal in orthopaedics and contribute towards the improvement of quality of orthopedic health care. The journal publishes original research work and review articles related to different aspects of orthopaedics including Arthroplasty, Arthroscopy, Sports Medicine, Trauma, Spine and Spinal deformities, Pediatric orthopaedics, limb reconstruction procedures, hand surgery, and orthopaedic oncology. It also publishes articles on continuing education, health-related information, case reports and letters to the editor. It is requested to note that the journal has an international readership and all submissions should be aimed at specifying something about the setting in which the work was conducted. Authors must also provide any specific reasons for the research and also provide an elaborate description of the results.
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