Journal of pediatric orthopedics
June 23, 2026 · via Europe PMC
Internal Extramedullary Lengthening of the Femur With an Intramedullary Lengthening Nail: Outcomes and Technical Considerations From 2 Centers.
Nahm NJ, Georgiadis AG, Bafor A, Iobst CA, Dahl MT.
AI summary — for doctors, generated from the abstract only
In a two-center review of 45 extramedullary motorized femoral lengthening procedures in young children, the technique achieved a median lengthening of 3.8 cm, but more than half of cases had at least one complication, with 12 requiring reoperation.
What was studied
A retrospective review across two centers of 40 patients who underwent 45 extramedullary motorized femoral lengthening procedures, evaluating complications, magnitude of lengthening achieved, and technical factors including antegrade versus retrograde nail placement technique.
Key findings
- Median follow-up was 27 months; antegrade lengthening was used in 40% of cases and retrograde in 60%.
- Median lengthening achieved was 3.8 cm, representing 14% of the femoral segment.
- At least one complication occurred in 56% of cases, with 12 complications classified as modified Clavien-Dindo grade III (requiring reoperation).
- There were no statistically significant differences in complication rates between antegrade and retrograde techniques.
Clinical relevance
The findings suggest extramedullary motorized femoral lengthening is a viable option for limb lengthening in young children (who may not be candidates for standard intramedullary nails due to small bone size), but families should be counseled about a substantial likelihood of complications, comparable to other femoral lengthening techniques.
Who should care
Limitations
This was a retrospective, two-center case series (Level IV evidence) without a direct comparison group using alternative lengthening techniques, limiting conclusions about relative complication rates compared with other methods.
A motorized limb-lengthening technique for young children's femurs achieved meaningful lengthening, but surgeons and families should expect a high likelihood of complications, with about one in four cases needing reoperation.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
Background
Surgical techniques for internal limb lengthening continue to advance. This study evaluates outcomes and technical aspects of extramedullary motorized femoral lengthening in young children.
Methods
A retrospective review of extramedullary motorized femoral lengthening at 2 centers was performed. Variables of interest include complications, the magnitude of lengthening, and technical factors, including antegrade versus retrograde techniques.
Results
Forty-five extramedullary motorized femoral lengthenings in 40 patients were included with a median follow-up of 27 months (range: 7.7 to 98.4 mo). Antegrade lengthening was performed in 40% of cases (18/45) and retrograde lengthening in 60% of cases (27/45). A median lengthening of 3.8 cm (14% of the femoral segment) was performed. At least one complication occurred in 56% of cases with 12 complications classified as modified Clavien-Dindo III (requiring a reoperation). There were no statistically significant differences in complication rates between antegrade and retrograde techniques.
Conclusions
Motorized extramedullary femoral lengthening is a viable treatment option for femoral lengthening in young children. The complication profile is comparable to other femoral lengthening techniques.
Level of evidence
Level IV.
DOI
10.1097/bpo.0000000000003380
PMID
42325153
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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