Psychological and orthopedic outcomes after stature lengthening surgery using intramedullary nails

• Main Authors: Michael Assayag, Joshua R Buksbaum, Nathan Khabyeh-Hasbani, Ellen Katz Westrich, Austin T Fragomen, S Robert Rozbruch
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2020-01-01
• Series: Journal of Limb Lengthening & Reconstruction
• Subjects: bone healing index; femur; limb lengthening; precice; self-esteem; stature lengthening; tibia
• Online Access: http://www.jlimblengthrecon.org/article.asp?issn=2455-3719;year=2020;volume=6;issue=1;spage=28;epage=32;aulast=Assayag

Introduction: Patients undergo stature-lengthening surgery (SLS) with the hope of improving their psychological health. The presumption is that increased height will improve body-image and self-esteem. The use of motorized internal lengthening nail and lengthening and then nailing techniques has eliminated or minimized time in external fixation increasing interest in the procedure. Material and Methods: Fifteen patients (32 bone segments) who underwent SLS were included in the study. All patients were bilateral, and one patient underwent four-segment treatments in two stages. Psychological assessment was performed with the body image quality of life inventory (BIQLI), the situational inventory of body-image dysphoria (SIBID), and the multidimensional body-self relations questionnaire before surgery and at latest follow-up. Orthopedic data included length obtained, bone healing index (BHI), adjacent joint range of motion, and Association for the Study and Application of Methods of Ilizarov (ASAMI). bone and functional scores. Results: The mean magnitude of lengthening was 64 ± 9.3 mm (48–77) (P < 0.001), resulting in an average increase from 161 cm to 167.4 cm. Mean BHI was 0.86 month/cm. ASAMI bone and functional results were all excellent after average follow-up of 37 months, with no loss of adjacent joint range of motion. BIQLI score significantly increased from 0.62 ± 1.26 (range −1.6–1.9) to 1.67 ± 0.85 (range −0.16–2.6) (P = 0.02). SIBID score significantly improved from 1.3 ± 0.81 (range 0.4–2.5) to 1.02 ± 0.68 (range 0.42–2.1) (P = 0.03). Discussion: Patients' significant increase in BIQLI score postoperatively, when compared to their scores preoperatively, demonstrate higher satisfaction in their body-image following SLS. Significant improvement in patients' SIBID score demonstrate a decrease in the impact of stature dysphoria in patients' everyday life following SLS. Conclusion: SLS is a safe and effective treatment to increase height. In patients, psychological health, including body-image and self-esteem, is improved.