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Humeral lengthening for septic neonatal growth arrest
1Department of Orthopedic Surgery, Beilinson Medical Center, Petah Tiqva, Israel.
Insights
This study details successful humeral lengthening in a 9-year-old girl with a significant limb length deficit. The procedure restored arm length and function, with a second stage planned for further growth.
Area of Science:
- Orthopedic surgery
- Pediatric orthopedics
- Limb reconstruction
Background:
- Congenital limb length discrepancies can significantly impact a child's development and function.
- Septic arthritis in infancy can lead to severe bone deformities and length deficits.
- Humeral lengthening is a surgical technique to address discrepancies in the upper arm.
Observation:
- A 9-year-old female presented with an 8.5 cm humeral length deficit secondary to neonatal septic arthritis.
- Surgical intervention involved a Wagner distraction apparatus following osteotomy distal to the deltoid insertion.
- The initial procedure achieved 6 cm of humeral lengthening.
Findings:
- The patient experienced no immediate complications following the humeral lengthening procedure.
- One-year follow-up demonstrated a full range of motion in the shoulder, elbow, and hand.
- Humeri length was nearly equalized after the first stage of lengthening.
Implications:
- Dividing limb lengthening into multiple stages may mitigate complications and optimize outcomes.
- Successful humeral lengthening can restore function and improve quality of life in children with limb length deficits.
- Further lengthening is planned to fully correct the deficit as the patient completes her growth phase.
Abstract:
A 9-year-old girl was treated by humeral lengthening for a 8.5 cm deficit caused by a septic arthritis 2 days after birth. A Wagner distraction apparatus was used after an osteotomy was done distal to the deltoid insertion. Six centimeters of length were gained. A second lengthening of about 7.5 cm is planned at the end of the patient's growth. No complications were encountered; by dividing the lengthening into two procedures, none are anticipated. At 1-year follow-up, there was a full range of shoulder, elbow, and hand motion; the humeri were virtually the same length.