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ORIGINAL ARTICLE
Year : 2020  |  Volume : 6  |  Issue : 1  |  Page : 28-32

Psychological and orthopedic outcomes after stature lengthening surgery using intramedullary nails


1 Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, MD, USA
2 College of Medicine, SUNYDownstate Health Sciences University, Brooklyn, New York, NY, USA
3 Limb Lengthening and Complex Reconstruction Service, Hospital for Special Surgery, Weill Medical College of Cornell University, New York, NY, USA
4 Department of Psychiatry, NYU Langone Medical Center, New York, NY, USA

Correspondence Address:
Dr. S Robert Rozbruch
Hospital for Special Surgery, 535 East 70th Street, New York, NY, 10021
USA
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jllr.jllr_4_20

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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.


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