Unilateral humeral lengthening in children and adolescents

This study evaluated the early experience with unilateral humeral lengthening in children and adolescents. Sixteen cases with unilateral humeral shortening ranged from 5.5-15 cm were studied. The etiology was Erb's palsy in eight cases, epiphyseal injury in five cases and infection in three cases. Hybrid fixation using wires and half pins was applied to all cases to minimize the risk of operative neurovascular complications. Osteotomy was performed in the middle 1/3 of the humerus through a posterior approach. After a latent period of 5-7 days, lengthening started at a rate of 1/3 mm every 8 hours. At an average follow up of 3 years and 2 months, ten excellent and six good results were achieved. The average healing index was 28 days/cm. The complications included pin tract infection in all cases, radial nerve palsy in one case and fracture of the regenerate in two cases

Forearm lengthening

In this study, 11 cases of forearm shortening underwent lengthening using Ilizarov principles. The etiology was hereditary multiple exostosis in six cases, radial club hand in two cases and traumatic in three cases. The average age at operation was 15.5 years [range 9-40 years]. The average follow up period was 3.5 years [range 2-6 years]. Eight good results, two fair results and one poor result were obtained. The area of lengthening achieved ranged from 2-11 cm of the original bone length. The average healing index was 40 days/cm. There were no neurovascular problems. Complications comprised some sort of pin tract infection in all cases, fracture of the regenerate in one case, breakage of a half pin in one case and increased carpal subluxation in another case. The combination of Ilizarov method and hybrid fixation provides a relatively safe method of forearm lengthening with the possibility of deformity correction and gradual reduction of chronic dislocations