Can a Checklist Protocol Improve Limb Lengthening?

Abstract

Background: In recent years, hexapodal external fixators and telescopic nails have improved the accuracy of limb lengthening and correction of deformities. However, careful follow-up in the postoperative period is extremely important; complications are still frequent and directly interfere with patient's outcome. Aims and Objectives: We have developed a follow-up limb lengthening reconstruction checklist. Materials and Methods: Like a flight checklist, professionals systematically record relevant data in every postoperative visit, to improve clinical management during distraction and consolidating phases. Results: LLR-Checklist was used in 53 consecutive patients, from 2006 to 2020. Average age was 11 (2-45) years. A pattern was found in the 18 patients with fibular hemimelia in relation to the use of antibiotics. Superficial infection was common. 21% of patients had delayed ossification in the regenerate. 25% of patients had nerve injuries; 9,4% of them had nerve decompression, all had total recovery. Contractures and pain improved with physical therapy. Conclusion: This checklist can improve quality in the treatment and is a valuable teaching tool for young practitioners.