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Humeral lengthening by distraction osteogenesis: a safe procedure?
[achondroplasia]
This
study
was
conducted
to
assess
the
safety
of
humeral
lengthening
using
an
Ilizarov
frame
.
We
retrospectively
reviewed
26
humeral
segments
in
17
patients
that
were
lengthened
at
our
department
between
1993
and
2011
.
There
were
varying
aetiologies
including
achondroplasia
,
epiphyseal
dysplasia
,
Oilier
disease
,
trauma
or
infection
of
the
proximal
humeral
growth
-plate
,
unicameral
bone
cyst
and
brachial
plexus
injury
.
Mean
age
at
start
of
surgery
was
17
.
05
years
(
range
:
5
-
40
)
.
The
mean
lengthening
achieved
was
8
.
85
(
3
-
13
)
cm
.
Mean
lengthening
percentage
was
353
%
(
range
:
10
-
48
)
.
Average
healing
index
was
30
.
56
days
/
cm
(
range
:
17
.
46
-
4232
)
.
There
was
a
significant
difference
in
healing
index
between
achondroplasia
patients
(
28
.
79
days
/
cm
)
compared
to
others
(
33
.
41
days
/
cm
)
.
Minor
problems
included
pin
tract
infection
(
14
segments
)
.
More
important
obstacles
were
temporary
elbow
flexion
contracture
(
7
segments
)
,
premature
consolidation
(
6
segments
)
,
radial
nerve
dysaesthesia
(
6
segments
)
and
loosening
of
a
Schanz
screw
(
1
segment
)
.
Complications
included
one
fracture
and
one
progressive
bowing
after
frame
removal
.
One
planned
lengthening
was
not
completely
achieved
.
Despite
a
lot
of
obstacles
,
humeral
lengthening
using
an
Ilizarov
frame
provided
a
reliable
method
to
treat
the
functional
or
cosmetic
problems
of
upper
limb
shortening
.
Diseases
Validation
Diseases presenting
"humeral segments"
symptom
achondroplasia
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