Non-Surgical Treatment of Lower Limb Axial Deformities in Developmental Age with L-System Technology: Results of a Consecutive Series of 25 Patients with Follow-up up to 15 Years

Objectives. To evaluate the clinical efficacy of L-System technology in the non-surgical treatment of lower limb axial deformities in developmental-age subjects, analysing the degree of reduction of the Intermalleolar Distance (IMD) in genu valgum and the Intercondylar Distance (ICD) in genu varum, and the long-term stability of results. Methods. Twenty-five consecutive patients aged 9 to 17 years (mean 12.9 years) treated at the Lauro Group S.r.l. pilot centre in Benevento, Italy, were retrospectively analysed. Of these, 17 presented with idiopathic genu valgum (grade IV in the majority of cases) and 8 with genu varum, all with associated global postural malalignment. Treatment was performed with the L-System automated biomechanical device according to a standardised protocol. The primary outcome was the variation in IMD/ICD before and after the treatment cycle. Results. In the genu valgum group (n=17), mean IMD decreased from 12.89 ± 1.47 cm to 1.44 ± 1.34 cm (mean reduction 89.1% ± 9.6%). In the genu varum group (n=8), mean ICD decreased from 7.22 ± 0.72 cm to 0.43 ± 0.47 cm (mean reduction 94.2% ± 6.6%). Across the entire series (n=25), mean reduction was 90.7% ± 9.1%; 60% of patients achieved reduction greater than 90% and 84% greater than 80%. Documented follow-up, available in 5 cases (maximum 15 years), confirmed long-term result stability. No patient required surgical conversion. Conclusions. L-System demonstrated clinically relevant efficacy in the conservative treatment of lower limb axial deformities in developmental age, with results superior to conventional physiotherapeutic approaches reported in the literature. Long-term stability and the absence of surgical conversions suggest its potential as a non-invasive alternative to paediatric orthopaedic surgery. Prospective controlled studies are warranted to consolidate the evidence profile.