2015

Landge, Vikrant; Shabtai, Lior; Gesheff, Martin G.; Specht, Stacy C.; Herzenberg, John E.

doi:10.3113/jsoa.2015.0174

Cited by 29 publications

(5 citation statements)

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“… 8 Some authors used locally developed patient satisfaction questionnaires. 14 , 23 Nevertheless, it is important to use validated HR-QOL to enable calculating the QALYs.…”

Section: Discussionmentioning

confidence: 99%

How Much Does Paediatric Femoral Lengthening Cost? A Cost Comparison between Magnetic Lengthening Nails and External Fixators

Madan,

Nicolaou,

Offiah

et al. 2023

Strategies in Trauma and Limb Reconstruction

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A bstract Aim Motorised intramedullary lengthening nails are considered more expensive than external fixators for limb lengthening. This research aims to compare the cost of femoral lengthening in children using the PRECICE magnetic lengthening nail with external fixation. Methods Retrospective analysis of 50 children who underwent femoral lengthening. One group included patients who were treated with PRECICE lengthening nails, the other group included patients who had lengthening with external fixation. Each group included 25 patients aged between 11 and 17 years. The patients in both groups were matched for age. Cost analysis was performed following micro-costing and analysis of the used resources during the different phases of the treatments. Results Each group's mean patient age was 14.7 years. Lengthening nails were associated with longer operative times compared with external fixators, both for implantation and removal surgery ( p -values of 0.007 and < 0.0001, respectively). Length of stay following the implantation surgery, frequency of radiographs and frequency of outpatient department appointments were all lower with lengthening nails. The overall cost of lengthening nails was £1393 more than external fixators, however, this difference was not statistically significant ( p -value = 0.088). Conclusion The difference in the mean costs between femoral lengthening with lengthening nails versus external fixators was not statistically significant. Further research to review the effectiveness of the devices and the quality of life during the lengthening process is crucial for robust health economic evaluation. How to cite this article Hafez M, Nicolaou N, Offiah A, et al. How Much Does Paediatric Femoral Lengthening Cost? A Cost Comparison between Magnetic Lengthening Nails and External Fixators. Strategies Trauma Limb Reconstr 2023;18(1):16–20.

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“… 8 Some authors used locally developed patient satisfaction questionnaires. 14 , 23 Nevertheless, it is important to use validated HR-QOL to enable calculating the QALYs.…”

Section: Discussionmentioning

confidence: 99%

How Much Does Paediatric Femoral Lengthening Cost? A Cost Comparison between Magnetic Lengthening Nails and External Fixators

Madan,

Nicolaou,

Offiah

et al. 2023

Strategies in Trauma and Limb Reconstruction

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“…Multiple studies compare the patients reported outcomes between lengthening nails and external fixators [ 10 , 11 , 15 ]. It was concluded that lengthening nails offered better patient satisfaction compared to external fixators.…”

Section: Discussionmentioning

confidence: 99%

“…Lengthening nails are more expensive than external fixators. This added cost of lengthening nails was argued to be in exchange for a better quality of life during the lengthening process [ 10 , 11 ]. Although this may be true, no studies have compared the quality of life between lengthening nails and external fixators during treatment.…”

Section: Introductionmentioning

confidence: 99%

Quality of life of children during distraction osteogenesis: a comparison between intramedullary magnetic lengthening nails and external fixators

Hafez

Nicolaou

Offiah

et al. 2022

International Orthopaedics (SICOT)

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Background Distraction osteogenesis is a very demanding process. For decades, external fixation was the only reliable option for gradual deformity correction. Recently, intramedullary magnetic nails have gained popularity. This research aimed to assess the quality of life in children during gradual deformity correction using intramedullary lengthening nails compared to external fixation. Method Prospective analysis included children who had gradual lower limb deformity correction between 2017 and 2019. Group A included children who had magnetic lengthening nails; patients in group B had external fixation devices. Child health utility 9D (CHU- 9D) and EuroQol 5D youth (EQ- 5D-Y) were used to measure the quality of life at fixed points during the distraction osteogenesis process. The results were used to calculate the utility at each milestone and the overall quality of life adjusted years (QALYs). Results Thirty-four children were recruited, group A had 16 patients, whilst group B had 18 patients. The average ages were 16.0 years and 14.7 years for groups A and B, respectively. Group A patients reported significantly better utility compared to group B. This was observed during all stages of treatment (P = 0.00016). QALYs were better for group A (0.44) compared to group B (0.34) (P < 0.0001). Conclusion The quality of life was generally better in group A compared to group B. In most patients, the health utility progressively improved throughout treatment. In the same way, QALYs were better with the lengthening nails compared to external fixators. The magnetic lengthening devices (PRECICE nails) which were used in this research were recently relabelled to restrict their applications in children; this study was conducted before these restrictions.

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“…The development of new motorised intramedullary lengthening nails enables deformity correction and limb lengthening with higher patient satisfaction and comfort than with external fixators [23]. …”

Section: Treatment Of Knee Instability In Congenital Limb Deficiencymentioning

confidence: 99%

The unstable knee in congenital limb deficiency

Mindler

Radler

Rudolf

2016

Journal of Children's Orthopaedics

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PurposeInstability of the knee is a common finding in patients with congenital limb deficiency. The instability can be attributed to soft tissue abnormalities, frontal, sagittal or rotational deformity of the lower limb and bony dysplasia of the patella or of the femoral condyles. In most of the cases, these pathomorphologic changes stay asymptomatic in daily activity. However, instability can appear during deformity correction and bone-lengthening procedures, leading to flexion contracture or subluxation of the knee.MethodsA review of pediatric orthopaedic literature on different factors of knee instability, state-of-the-art treatment options in congenital limb deficiency and in cases of lengthening-related knee subluxation is presented and the authors’ preferred treatment methods are described.ResultsLeg lengthening and deformity correction in patients with congenital limb deficiencies can be achieved with various techniques, such as guided growth, monolateral or circular external fixation and intramedullary lengthening nails. Radiographic assessment and clinical examination of the knee stability are obligatory to estimate the grade of instability prior to surgical procedures. Preparatory surgery, as well as preventive measures such as bracing, bridging of the knee and intensive physical therapy, can help to avoid subluxation during lengthening in unstable knees.ConclusionsAdequate surgical techniques, preventive measures and early detection of signs of subluxation can lead to good functional results in patients with congenital limb deficiency.

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2015

Cited by 29 publications

References 0 publications

How Much Does Paediatric Femoral Lengthening Cost? A Cost Comparison between Magnetic Lengthening Nails and External Fixators

How Much Does Paediatric Femoral Lengthening Cost? A Cost Comparison between Magnetic Lengthening Nails and External Fixators

Quality of life of children during distraction osteogenesis: a comparison between intramedullary magnetic lengthening nails and external fixators

The unstable knee in congenital limb deficiency

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