Retrospective review of 50 consecutive PRECICE/STRYDE intramedullary nail lengthenings in 42 pediatric and adolescent patients (ages 12-17) at a single center. The study reports nail accuracy, consolidation parameters, weight-bearing timelines, ASAMI scores, and patient satisfaction to guide protocol-level management of this population.
Intramedullary lengthening nails in the pediatric population were adopted from adult practice, but dedicated outcome data guiding protocols for children and adolescents were scarce before this series.
When planning a lengthening case in a skeletally immature patient, use trochanteric entry nails for open physes to protect the femoral head blood supply. For tibial cases, build in extra time — tibias consolidate at 39 d/cm vs. 28 d/cm for femur, roughly 40% longer.
If joint stiffness develops beyond 30 mm of lengthening, slow the distraction rate first and increase physiotherapy to twice weekly before considering a pause. All 7 stiffness cases in this series resolved without surgery using this stepwise approach.
Fibrous dysplasia patients are higher risk: the one major complication in this series was a periprosthetic fracture in that pathology, and elective exchange to a trauma nail after consolidation is a reasonable precaution in this group.
Retrospective review of 50 consecutive PRECICE/STRYDE intramedullary nail lengthenings in 42 pediatric and adolescent patients (ages 12-17) at a single center. The study reports nail accuracy, consolidation parameters, weight-bearing timelines, ASAMI scores, and patient satisfaction to guide protocol-level management of this population.
Intramedullary lengthening nails in the pediatric population were adopted from adult practice, but dedicated outcome data guiding protocols for children and adolescents were scarce before this series.
When planning a lengthening case in a skeletally immature patient, use trochanteric entry nails for open physes to protect the femoral head blood supply. For tibial cases, build in extra time — tibias consolidate at 39 d/cm vs. 28 d/cm for femur, roughly 40% longer.
If joint stiffness develops beyond 30 mm of lengthening, slow the distraction rate first and increase physiotherapy to twice weekly before considering a pause. All 7 stiffness cases in this series resolved without surgery using this stepwise approach.
Fibrous dysplasia patients are higher risk: the one major complication in this series was a periprosthetic fracture in that pathology, and elective exchange to a trauma nail after consolidation is a reasonable precaution in this group.