Operative lengthening of the humerus: indications, benefits, and complications

The purpose of this study was to determine the benefits and risks of humeral lengthening procedures. Distraction osteogenesis was performed in 19 humeri on 16 patients (9 males, 7 females). The mean age at the time of lengthening was 11.5 years (range 3-24 years) and average follow-up was 8.7 years (range 2-21 years). Etiologies for short humeri included infection in six patients, congenital anomaly in six patients, unicameral bone cysts involving the physis in five patients, and posttraumatic growth disturbance in two patients. The average lengthening was 5 cm. The benefits from humeral lengthening include increased performance in daily activities, improved sports performance, and significantly better self-image. Complications included temporary radial nerve palsy in three cases, drainage from the pin tracts in two cases, elbow flexion contracture in three cases, and late humerus fracture in two cases. All the complications resolved over time and did not affect the outcome. Eleven lengthening procedures were not associated with any complications. Although the humerus is surrounded by complex neurovascular structures and muscles, humerus lengthening provided satisfactory results with temporary minor complications.