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Purpose <p>To systematically review the efficacy, safety, and outcomes of limb lengthening procedures in patients with achondroplasia, including effects on quality of life.</p> Methods <p>Following PRISMA guidelines, a systematic review and meta-analysis was performed. Eligible studies included patients with achondroplasia who underwent limb lengthening of the upper and/or lower extremities. Data were extracted on length gain, external fixator index, fixation duration, complications, and quality of life. Pooled means and 95% confidence intervals (CIs) were calculated using single-arm meta-analysis.</p> Results <p>Fourteen studies including 1149 patients were analyzed. The mean femoral gain was 8.85&#xa0;cm (95% CI: 7.42–10.28), tibial gain 7.36&#xa0;cm (95% CI: 6.21–8.52), and humeral gain 8.38&#xa0;cm (95% CI: 7.01–9.74). The mean fixator index was 37.1&#xa0;days/cm (95% CI: 32.37–41.82), with a mean fixation duration of 7.71&#xa0;months (95% CI: 5.98–9.63). The overall complication rate was 56.1% (95% CI: 26.9–85.2). Importantly, the pooled quality of life score measured by the Paediatric Quality of Life Inventory was 75.69 (95% CI: 65.14–86.23), indicating moderate improvement despite high treatment burden.</p> Conclusion <p>Limb lengthening in achondroplasia achieves significant stature and proportional gains but requires prolonged treatment and carries a high complication risk. Nevertheless, improvements in functional ability and quality of life are evident, particularly when multi-limb lengthening is performed. Future studies should standardize outcome reporting, assess long-term QoL trajectories, and evaluate newer technologies such as intramedullary nails combined with multidisciplinary support.</p>

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Efficacy and safety of limb lengthening in achondroplasia: A systematic review and meta-analysis

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年3月16日

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  • Gamal Hosny,
  • Ahmed AbdElnaser,
  • Abdelrahman Elashhab,
  • Hossam Saad

摘要

Purpose

To systematically review the efficacy, safety, and outcomes of limb lengthening procedures in patients with achondroplasia, including effects on quality of life.

Methods

Following PRISMA guidelines, a systematic review and meta-analysis was performed. Eligible studies included patients with achondroplasia who underwent limb lengthening of the upper and/or lower extremities. Data were extracted on length gain, external fixator index, fixation duration, complications, and quality of life. Pooled means and 95% confidence intervals (CIs) were calculated using single-arm meta-analysis.

Results

Fourteen studies including 1149 patients were analyzed. The mean femoral gain was 8.85 cm (95% CI: 7.42–10.28), tibial gain 7.36 cm (95% CI: 6.21–8.52), and humeral gain 8.38 cm (95% CI: 7.01–9.74). The mean fixator index was 37.1 days/cm (95% CI: 32.37–41.82), with a mean fixation duration of 7.71 months (95% CI: 5.98–9.63). The overall complication rate was 56.1% (95% CI: 26.9–85.2). Importantly, the pooled quality of life score measured by the Paediatric Quality of Life Inventory was 75.69 (95% CI: 65.14–86.23), indicating moderate improvement despite high treatment burden.

Conclusion

Limb lengthening in achondroplasia achieves significant stature and proportional gains but requires prolonged treatment and carries a high complication risk. Nevertheless, improvements in functional ability and quality of life are evident, particularly when multi-limb lengthening is performed. Future studies should standardize outcome reporting, assess long-term QoL trajectories, and evaluate newer technologies such as intramedullary nails combined with multidisciplinary support.