Preprint Article Version 1 This version is not peer-reviewed

Evaluation of Physical and Mental Health in Adults Who Underwent Limb-Lengthening Procedures with Circular External Fixators during Childhood or Adolescence

Alessandro Depaoli
* ,
Marina Magnani
,
Agnese Casamenti
,
Marco Ramella
,
Grazia Chiara Menozzi
,
Giovanni Gallone
,
Marianna Viotto
,
Gino Rocca
,
Giovanni Trisolino
*
Version 1 : Received: 19 August 2024 / Approved: 20 August 2024 / Online: 20 August 2024 (12:35:02 CEST)

How to cite: Depaoli, A.; Magnani, M.; Casamenti, A.; Ramella, M.; Menozzi, G. C.; Gallone, G.; Viotto, M.; Rocca, G.; Trisolino, G. Evaluation of Physical and Mental Health in Adults Who Underwent Limb-Lengthening Procedures with Circular External Fixators during Childhood or Adolescence. Preprints 2024, 2024081449. https://doi.org/10.20944/preprints202408.1449.v1 Depaoli, A.; Magnani, M.; Casamenti, A.; Ramella, M.; Menozzi, G. C.; Gallone, G.; Viotto, M.; Rocca, G.; Trisolino, G. Evaluation of Physical and Mental Health in Adults Who Underwent Limb-Lengthening Procedures with Circular External Fixators during Childhood or Adolescence. Preprints 2024, 2024081449. https://doi.org/10.20944/preprints202408.1449.v1

Abstract

Background: Lower limb length discrepancy (LLD) in children and adolescents, often due to congenital or acquired conditions, is treated to achieve limb equality and alignment, optimizing function and minimizing cosmetic concerns for an active adulthood. This study evaluated the Health-Related Quality of Life (HRQoL) and physical functioning of adults who underwent unilateral limb lengthening with circular external fixators (EFs) in childhood. Methods: Fifty patients treated at a median age of 14.9 years completed the Short Form 36 (SF-36) and Stanmore Limb Reconstruction Score (SLRS) questionnaires in adulthood, with a median follow-up of 8.9 years. Results: Among the 50 patients, 38 underwent a single limb lengthening (21 tibia, 12 femur, 5 both), while 12 required multiple cycles. The median residual LLD was 0.4 cm, with 12 patients (24%) having over 2 cm. Complications occurred in 67% of procedures, mainly due to prolonged healing. Physical and mental health scores were significantly lower than normative data. The mean Physical Component Summary was 52.2 ± 7.2 (p = 0.20). The mean Mental Component Summary was 43.9 ± 8.6 (p = 0.001), notably lower in congenital LLD cases. Many SLRS items (Pain, Social, Physical Function, Work, and Emotions) strongly correlated with SF-36 items. Conclusions: The study highlights the challenges in treating LLD, emphasizing the significant mental health impact, especially in congenital cases, and the necessity for comprehensive long-term care strategies. These findings suggest that future therapeutic strategies should focus on both physical and psychological outcomes to improve overall recovery in LLD treatment.

Keywords

limb lengthening; Ilizarov; external fixation; congenital; pediatric; Patient-Reported Outcomes; Short Form 36; Stanmore Limb Reconstruction Score

Subject

Medicine and Pharmacology, Orthopedics and Sports Medicine

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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