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External fixators and lengthening systems in pediatric upper limb.

Nunzio Catena1, Chiara Arrigoni1, Marcos Carvalho2

  • 1Hand Surgery and Reconstructive Microsurgery Unit, IRCCS Istituto Giannina Gaslini, Genova, Italy.

Journal of Children'S Orthopaedics
|March 20, 2025
PubMed
Summary
This summary is machine-generated.

External fixators are crucial in orthopedic surgery for bone lengthening, especially in pediatric upper limbs for various conditions. While monoaxial fixators remain important, newer technologies like hexapod systems may offer future solutions for complex deformities.

Keywords:
External fixatorpediatric deformitiesupper limb

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Area of Science:

  • Orthopedic Surgery
  • Biomechanical Engineering
  • Pediatric Orthopedics

Background:

  • External fixators are integral to orthopedic surgical practice.
  • Advancements in fixator design and biomechanics have improved bone lengthening techniques.
  • Distraction osteogenesis is a key biological principle in skeletal lengthening.

Purpose of the Study:

  • To review the literature on external fixators and lengthening systems in pediatric upper limb applications.
  • To explore the indications and challenges of external fixation in the upper limb.
  • To compare different fixation methods for humeral lengthening and forearm deformity correction.

Main Methods:

  • Literature review of external fixator and lengthening system applications in pediatric upper limbs.
  • Analysis of indications including trauma, congenital conditions, tumors, and infections.
  • Evaluation of monolateral, circular, monoaxial, and hexapod frame systems.

Main Results:

  • External fixator use in upper limbs is less common than in lower limbs but indicated for diverse etiologies.
  • Debate continues regarding optimal fixation methods, especially for humeral lengthening and forearm deformities.
  • Monoaxial fixators are widely used, but motorized intramedullary nails may surpass them for humeral lengthening.
  • Hexapod systems show promise for multiplanar forearm deformities.

Conclusions:

  • External fixation remains relevant for pediatric upper limb conditions, despite evolving technologies.
  • Further multicenter studies are needed to validate the efficacy of advanced systems like hexapods.
  • The choice between different fixation methods requires careful consideration of the specific clinical scenario.