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Topic:

Achondroplasia

Issue:

Thigh

Category:

Congenital

Title:

Prophylactic Intramedullary Rodding After Femoral Lengthening in Patients With Achondroplasia and Hypochondroplasia

Author:

Rovira Martí, Pilar MD; Ginebreda Martí, Ignacio MD; García Fontecha, César MD, PhD

Journal:

Journal of Pediatric Orthopaedics

Date:

March 2024

Reference:

44(3): p e249-e254, DOI: 10.1097/BPO.0000000000002594

Level Of Evidence:

III

# of Patients:

43 patients (86 femoral lengthening procedures

Study Type:

Retrospective comparative study

Location:

Multicenter study

Summary:

This study evaluates the effectiveness of prophylactic intramedullary rodding in preventing femoral fractures following femoral lengthening procedures in patients with achondroplasia and hypochondroplasia.

Methods:

Participants: 43 patients with achondroplasia or hypochondroplasia (mean age 14.9 years, 11 females and 10 males). Intervention: Patients were divided into two groups: Prophylactic Rodding Group: 42 femora (21 patients) received intramedullary Rush rodding after external fixation removal. Non-rodding Group: 44 femora (22 patients) did not receive rodding. Outcome Measures: The study compared the incidence of femoral fractures between the two groups.

Exclusions:

Not specified

Results:

Fracture Incidence: 15.9% (7 cases) of the non-rodding group developed femoral fractures, with 4 requiring surgical correction. Rodding Group: Only 2.4% (1 case) developed a femoral fracture, and no surgery was required. Statistical Significance: The incidence of fractures was significantly lower in the prophylactic rodding group compared to the non-rodding group (2.4% vs. 15.9%, P = 0.034). Complications: No infections or avascular necrosis were reported in either group.

Conclusions:

Prophylactic intramedullary rodding significantly reduces the risk of femoral fractures after femoral lengthening in patients with achondroplasia and hypochondroplasia. This approach is both safe and effective, with a low incidence of fractures and no complications.

Relevance:

Limitations:

Perspective:

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