Femoral lengthening in young patients: An evidence-based comparison between motorized lengthening nails and external fixation

Table 3 Quality assessment of included publications

Strengths	Limitations
Black et al[14]
(1) Clear methodology: Objective, design, inclusion / exclusion criteria, outcome, and results; (2) Age matched participants; (3) All participants had the same underlying diagnosis; and (4) Complications were described in detail	(1) Clinical and radiological outcome results were not declared due to compassionate use policy; (2) Selection bias; (3) All participants were skeletally mature (not fully representing the Paediatric population); (4) No validated scores were used; (5) No attempt was made to avoid observer bias; and (6) Sample size calculations were not undertaken
Szymczuk et al[13]
(1) Clear methodology: Objective, design, inclusion/exclusion criteria, outcome, and results; (2) The study focused only on children; (3) All participants had the same underlying diagnosis; (4) Probability values (P values) were reported; and (5) Complications were described in detail	(1) Bias such as selection and follow up; (2) There is no mention of potential confounders or how they may have varied between groups; (3) No validated scores were used; (4) No attempt was made to avoid observer bias; (5) Nails were used only in older children, resulting in uneven distribution of the intervention especially in the higher-risk younger age group; and (6) Sample size calculations were not undertaken