Strategies in Trauma and Limb Reconstruction

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VOLUME 18 , ISSUE 1 ( January-April, 2023 ) > List of Articles

Original Article

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

Mohamed Hafez, Nicolas Nicolaou, Amaka Offiah, Phillips Obasohan, Simon Dixon, Stephen Giles, Sanjeev Madan, James Alfred Fernandes

Keywords : Cost analysis, Distraction osteogenesis, External fixator lengthening, Femoral lengthening, Hybrid lengthening, Intramedullary lengthening, Lengthening nail, Limb lengthening, Motorised implantable nail, Short stature

Citation Information : Hafez M, Nicolaou N, Offiah A, Obasohan P, Dixon S, Giles S, Madan S, Fernandes JA. How Much Does Paediatric Femoral Lengthening Cost? A Cost Comparison between Magnetic Lengthening Nails and External Fixators. 2023; 18 (1):16-20.

DOI: 10.5005/jp-journals-10080-1573

License: CC BY-NC-SA 4.0

Published Online: 31-05-2023

Copyright Statement:  Copyright © 2023; The Author(s).


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.

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