[Results of lengthening 20 humeri]

Area of Science:

• Orthopedic surgery
• Pediatric orthopedics
• Limb reconstruction

Background:

• Limb length discrepancies in children can result from various causes including infection, trauma, congenital conditions, and bone cysts.
• Surgical intervention for significant humerus shortening is often necessary to address functional and cosmetic concerns.

Purpose of the Study:

• To evaluate the outcomes of 20 humerus lengthening procedures performed in 18 pediatric patients.
• To assess the safety and efficacy of the callotasis method for humerus lengthening.

Main Methods:

• Retrospective analysis of 20 humerus lengthening procedures in 18 patients (7 boys, 13 girls) between 1983 and 1999.
• Indications included shortening of at least 50 mm due to infection, trauma, congenital issues, or bone cysts.
• Lengthening utilized external fixation devices, predominantly the Wagner unilateral fixator, with osteotomy between the distal and middle thirds of the humerus, ensuring radial nerve visualization.

Main Results:

• Mean lengthening achieved was 71 mm over a mean distraction phase of 91 days.
• The mean total fixation period was 197 days, with full bone consolidation occurring at a mean of 355 days.
• Bone lengthening index averaged 13.2 days/cm, bone healing index was 28.6 days/cm, and a modified index was 44.5 days/cm. No bone grafting or plate osteosynthesis was required.
• Three cases of transient radial nerve palsy occurred, resolving spontaneously.

Conclusions:

• Humerus lengthening using the callotasis method is a safe and successful treatment for cosmetic length deficiency in children and adolescents.
• The procedure demonstrated uneventful distraction and bone healing, comparable to large international cohorts.
• Maintaining the principles of callotasis is crucial for an uncomplicated treatment program.