[Arm lengthening in children. Report of 4 cases]

The principle of osteogenesis under stretch elaborated by Pr. G.A. Ilizarov around 1970 comfort our decision for limb lengthening for it does not need in most cases hemorrhagic operations nor use of bone grafts. Pathological shortening of the humerus may be due to various causes: monomelic dystrophy due to epiphysiodesis of humeral superior growing plate with or without humerus varus, sequelae of neonatal septic osteoarthritis of the shoulder joint are the more frequent etiologies. On the other hand, the fibrous dysplasia, osteochondromatosis (Ollier's disease), sequelae to trauma or iatrogenic etiologies are infrequent. Resulting length discrepancy are very important from 11 to 15 cm and more when growth is achieved. Functional disorders are delayed as compared to the lower limb for each upper limb acts independently to each other. However above 6 cm discrepancy coordinated movements become more difficult or impossible especially above 8 cm discrepancy. The authors reported 4 cases of arm lengthening concerning teenagers by Ilizarov's technique with a discrepancy between 10 to 14 cm. One of the humerus was previously treated by Wagner's technique which allow us to make a comparative analysis of both methods. Technical instructions, incidents and accidents occurring during lengthening, healing delays and functional and esthetic results are discussed in recent publications on this subject.