Complications of Fitbone and Precice intramedullary bone lengthening nails: a systematic review with 782 patients

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Abstract

Background: More than 16000 intramedullary Precice and Fitbone lengthen- ing nails have been implanted worldwide. Complications are so far only hetero- geneously reported in small case series, and no systematic overview of compli- cations exists.
Purpose / Aim of Study: To perform a systematic literature review of compli- cations with Fitbone and Precice bone lengthening nails in lower extremity bone lengthening.
Materials and Methods: In PubMed, EMBASE, Cochrane Library a systematic search, with no limits concerning study design, date or language, was performed with search string of medical subject headings: Bone Nails, Bone Lengthening and “Word” Fitbone and Precice nail. One author selected the articles. The first and last author assessed complications. Complications were severity graded (Black et al. 2015) and categorized into subgroups based on origin.
Findings / Results: The search found 952 articles, 116 were full text screened and 41 included. 983 segments were lengthened in 782 patients (age: 8-74 years). Number of patients: 208 congenital, 305 acquired limb shortening, 111 short status, 158 unidentified etiology. We identified 332 complications (34% of segments). Type I (minimal intervention): 11% of segments; Type II (substan- tial change in treatment plan): 15% of segments; Type IIIA (failure to achieve goal): 5% of segments; Type IIIB (new pathology or permanent sequelae): 3% of segments. Joint contracture/subluxation/luxation was the most frequent type IIIB complication. The two most frequent origins of complications were related to device (13% of segments) and bone (9% of segments).
Conclusions: The risks of complications represent average risks as data did not allow stratification of risks based on etiology of lengthening. Intramedullary lengthening nails were introduced to reduce complications in limb lengthening. The overall risk of complication is still high with one complication for every three segments lengthened. In one of every four segments, the complication has a major impact on treatment: substantial change in treatment, such as unplanned surgery (15%), failure of achieving lengthening goal (5%) or introduction of a new pathology or permanent sequelae (3%).
Original languageEnglish
Publication dateOct 2020
Number of pages1
Publication statusPublished - Oct 2020
EventDansk Ortopædkirurgisk Selskab kongress - , Denmark
Duration: 22 Oct 202022 Oct 2020

Conference

ConferenceDansk Ortopædkirurgisk Selskab kongress
CountryDenmark
Period22/10/202022/10/2020

Bibliographical note

The Congress was cancelled due to COVID-19

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