Abstract
INTRODUCTION: As limb lengthening techniques have evolved from external fixation to motorized internal lengthening nails (MILN), it is anticipated that the length of stay (LOS) required and the readmission rates reported after these procedures will improve. The primary aim of this study was to describe the length of stay and readmission rates in a contemporary lengthening cohort. The secondary aim was to explore variables associated with LOS and readmission rates. METHODS: This was a retrospective cohort study analyzing 213 limb lengthening events at a single center between October 2016 and June 2022. Most patients were male (145/213; 68%), White (126/213; 59%), and privately insured (183/213; 86%). Linear regression, Mann-Whitney U, and Kruskal-Wallis tests were used to analyze the effects of independent variables on LOS. Binary logistic regression or Pearson Chi-square test were used to analyze the effects of independent variables on readmission (postdischarge hospitalization of >24 hours). RESULTS: The median LOS was 3 days (IQR 2 to 3 days). The mode LOS was 2 days occurring after 89 of 213 procedures (41.8%). Increasing age ( P = 0.002), patient-reported ethnicity ( P = 0.037), and surgical day of the week ( P < 0.001) were associated with increased length of stay. Patient sex ( P = 0.317), insurance status ( P = 0.166), concurrent deformity correction ( P = 0.811), and bilateral lengthening ( P = 0.314) were not associated with LOS. Overall, 30 readmission events (14.1%) were reported; most commonly delayed union requiring fixation exchange in 16 of 30 readmissions (53%). The only variable statistically significantly associated with readmission was increasing age ( P = 0.003). CONCLUSION: The median length of stay was 3 days with a mode of 2 days. The readmission rate was 14.1%. Increasing age, patient ethnicity, and surgical day of the week were associated with increased LOS, whereas readmission was associated with increasing age. This characterization may help as a guide when counseling patients on the expected postoperative course for a limb lengthening procedure.