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 "premature consolidation" symptom

achondroplasia

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