New findings in limb lengthening and deformity correction are highlighted in the latest JBJS Specialty Update, What’s New in Limb Lengthening and Deformity Correction. Here, we summarize the 5 most compelling studies, as selected by coauthor Bjoern Vogt, MD.
Intramedullary Lengthening Nails
A total of 286 bone-lengthening events using the PRECICE nail (NuVasive) at a single center were retrospectively analyzed to assess the bone healing index (BHI) by surgical approach. The mean BHI was more favorable with an antegrade femoral approach than with a retrograde femoral or antegrade tibial approach1. The findings “confirmed that regenerate consolidation is strongly approach-dependent and segment-dependent,” write Specialty Update authors Drs. Vogt et al.
The rate of osteonecrosis following femoral lengthening with intramedullary lengthening nails was analyzed in a large retrospective study published in JBJS. A total of 247 patients with a mean age of 17 years and at least 2 years of follow-up were included. The investigators found that none of the patients had radiographic evidence of osteonecrosis (the primary outcome) or coxa valga2.
Congenital Deficiencies
Researchers performed a descriptive study of a multicenter cohort of 103 patients with fibular hemimelia in France. Most patients (81%) underwent at least 1 lengthening procedure. Leg-length discrepancy correction was satisfactory, with a median final discrepancy of <2 cm. However, a high (73%) complication rate following leg-lengthening surgery was observed3.
Physeal Arrest
In a study published in JBJS, a rabbit proximal tibial physeal fracture model was used to investigate the effect of acute placement of fat autograft at the time of fracture reduction. Fat autograft interposition was not associated with a difference in the probability of physeal bar formation. The researchers concluded that “Fat autograft interposition did not reliably prevent radiographic bar formation or angular deformity when placed during physeal fracture reduction.”4
Guided Growth and Growth Modulation
A retrospective study investigated risk factors for reoperation in 91 patients (142 knees) who underwent guided growth using tension-band plates for genu varum and valgum deformities. Nearly 40% of patients underwent reoperation, most commonly for deformity recurrence or slow response. Younger age and non-idiopathic etiologies were identified as risk factors5.
What’s New in Limb Lengthening and Deformity Correction is freely available at JBJS.org.
What’s New by Subspecialty
Each month, JBJS publishes a review of the most pertinent studies from the orthopaedic literature in a select subspecialty. To read the reports, visit the What’s New by Subspecialty collection at JBJS.org.
Recent OrthoBuzz posts include: What’s New in Musculoskeletal Infection, What’s New in Spine Surgery, and What’s New in Sports Medicine.
References
- Reif TJ, Khabyeh-Hasbani N, Buksbaum J, Sheridan GA, Hoellwarth JS, Fragomen AT, Rozbruch SR. Bone Healing Index and complications of a magnetic internal lengthening nail: a retrospective series of 286 bone lengthening events. J Am Acad Orthop Surg Glob Res Rev. 2025 May 22;9(6):e25.00118.
- Dubin JA, Swartz GN, Bains SS, Gottlich C, Herzenberg JE, McClure PK. Rate of osteonecrosis after femoral lengthening with intramedullary lengthening nails. J Bone Joint Surg Am. 2025 Apr 16;107(8):878-82.
- Couvreur A, Cordonnier T, Bard T, Pesenti S, Ravot C, Accadbled F, Josse A, Morin C, Kipper B, Souchet P, Payen M, Budiartha L, Bachy-Razzouk M, Fraisse B, Pejin Z, Launay F; Société Française d’Orthopédie Pédiatrique (SoFOP). French experience in the management of fibular hemimelia: radiographic and functional outcomes. Orthop Traumatol Surg Res. 2025 Sep;111(5):104309.
- Tretiakov MS, Farnsworth CL, Rupp GE, Gordon KE, Ponce KA, Berry DB, Tucker SM, Edmonds EW. Acute interpositional fat autograft does not protect against bar formation in physeal fractures. J Bone Joint Surg Am. 2025 May 22;107(13):1489-99.
- Pan YT, Lee MC, Wang SY, Kao HK, Chang CH. Risk factors for reoperations following guided growth around the knee. J Orthop Sci. 2026 May;31(3):658-63.
Image reproduced from: Couvreur A, Cordonnier T, Bard T, Pesenti S, Ravot C, Accadbled F, Josse A, Morin C, Kipper B, Souchet P, Payen M, Budiartha L, Bachy-Razzouk M, Fraisse B, Pejin Z, Launay F; Société Française d’Orthopédie Pédiatrique (SoFOP). French experience in the management of fibular hemimelia: radiographic and functional outcomes. Orthop Traumatol Surg Res. 2025 Sep;111(5):104309. The image is available under a Creative Commons license.