Outcomes Following Sequential Internal Lengthening of the Femur: A Case Series
Anirejuoritse Bafor, Bicheng Yong, Christopher IobstAbstract
Introduction:
Internal lengthening nails have enhanced the patient experience in limb lengthening, but soft-tissue complications such as neuropathies and joint contractures continue to limit the degree of correction achievable in a single procedure. In progressive conditions like congenital limb deficiencies, limb length discrepancy (LLD) may recur over time, necessitating repeat interventions. This study evaluated outcomes in patients who underwent two consecutive internal femoral lengthening procedures.
Materials and Methods:
Seven patients who had sequential internal femoral lengthenings were retrospectively reviewed. Diagnoses included congenital femoral deficiency (
Results:
The cohort comprised four males and three females, with a mean age of 9.9 ± 5.1 years at the first lengthening. The left femur was lengthened in five cases. The median interval between procedures was 46 months (interquartile range: 25 months). The BHI was generally higher during the second lengthening than during the first (median 28.2 vs. 25.6 days/cm), although the direction and magnitude of the change differed between patients. However, bone regenerate maturation after the second lengthening was less predictable, showing a wider BHI range (12.5–42.8 days/cm).
Conclusion:
Repeat femoral lengthening using an internal lengthening nail is both feasible and safe, with comparable bone healing to the initial procedure. Increased variability in healing during the second lengthening warrants further study to identify factors influencing bone regeneration consistency.