Results of humeral lengthening w ith u nilateral e xternal f ixator
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Results of Humeral Lengthening W ith U nilateral E xternal F ixator. Short Humerus. S pinal flexibility decreases by agin g that cause l imitation of upper limb function self service personal and perineal hygiene C osmetic P sychologic F unctional problems.

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Results of Humeral Lengthening W ith U nilateral E xternal F ixator

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Results of humeral lengthening w ith u nilateral e xternal f ixator

Results of Humeral Lengthening With Unilateral External Fixator


Short humerus

Short Humerus

  • Spinal flexibility decreases by aging that cause limitation of

    upper limb function

    • self service

    • personal and perineal hygiene

  • Cosmetic

    Psychologic

    Functional problems.


Humerus lengthening with circular ex fix

HumerusLengtheningwithCircularEx. Fix.

  • Cattaneo R, Catagni MA, Guerreschi F. Applications of theIlizarovmethod in thehumerus. Lengtheningsandnonunions.HandClin. 1993 Nov;9(4):729-39.

  • Cattaneo R, Villa A, Catagni MA, Bell D.Lengthening of thehumerususingtheIlizarovtechnique. Description of themethodandreport of 43 cases.Clin Orthop Relat Res. 1990 Jan;(250):117-24.

  • Yasui N, Kawabata H, Nakase T, Shibata T, Ohno H, Ochi T. Humerallengtheninganddeformitycorrection. Orthopade. 2000 Jan;29(1):58-62. German.

  • Kashiwagi N, Suzuki S, Seto Y, Futami T. Bilateralhumerallengthening in achondroplasia. ClinOrthopRelatRes. 2001 Oct;(391):251-7

  • GamalAhmedHosny. Unilateral humeral lengthening in children and adolescents.Journal of Pediatric Orthopaedics B 2005, 14:439–443


Humerus lengthening with unilateral ex fix

Humerus Lengthening With Unilateral Ex. Fix.

  • Poul J, Syebis M. Results of lengthening 20 humeri. ActaChirOrthopTraumatolCech. 2001;68(5):289-93.

  • Cordonnier D, Barbier J, Desrousseaux JF. Severe angulardeformity of thehumerus: unilateralexternalfixationforcorrectionand bone lengthening. RevChirOrthopReparatriceApparMot. 2004 Feb;90(1):83-7.

  • Francis Young-In Lee, MD, J. Scott Schoeb, MD, John Yu, BS,Brett D. Christiansen, MD, and Harold M. Dick, MD.Operative Lengthening of the HumerusIndications, Benefits, andComplications. J Pediatr Orthop 2005;25:613–616

  • Shadi M, Koczewski P. Humerallengtheningwith a monolateralexternalfixator in achondroplasia. Pediatr EndocrinolDiabetesMetab. 2007;13(3):121-4.

  • SándorKiss& KárolyPap & TiborVízkelety & Tamás Terebessy & Mária Balla & György Szőke. The humerus is the best place for bone lengthening. InternationalOrthopaedics (SICOT) (2008) 32:385–388


Humerus lengthening

HumerusLengthening

  • We use Unilateral external fixator (U.E.F.)

    • since 2001

    • in all cases

    • more comfortable

  • Prophylactic radial nerve release in all.

A.B. 6 Years. M. 6 cm.45%

A.K. 8 Years. M. SED. 10 CM .95%


Humerus lengthening with u e f

HumerusLengtheningWith U.E.F

  • Between 2001 and 2009

  • Mean age 11.9 (range, 30-4) years

  • 27 humeri in 18 patients

A.K. 8 Years. M. SED. 10 CM 95%


Etiology

Etiology

  • 9 bilateral

    7 achondroplasia

    2 epiphysealdysplasia

  • 9 unilateral

    4 septic artritis

    2 tumor sequelae

    3 hemimelia

N.P. 7 years. F.Achondroplasia. 6 cm. 50%

A.M. 23 Years.F. Post infection. 8 cm .40%


Result

Result

  • Mean follow-up 49 months (range, 11-104).

  • Mean EFT 216 days (range, 120-510 )

  • Mean EFI 33,1 (range, 19– 50 ) days/cm.

B.K.. 17 Years. M. Epiphysitis. 7,5 cm. 47%


The m ean l engthening r ate

The Mean Lengthening Rate

  • The mean lengthening 7,26 cm (range, 3,7-12 cm).

    56 % (25- 95 %)

    66 % (45- 95 %) in achondroplasia.

M.G. 7 Years.M. Achondroplasia.

9.5 cm . 95%


Circulair type fixators

CirculairTypeFixators


U e f

U.E.F.


P aley s f unctional s cores

Paley’s Functional Scores

  • Excellent in 11,

  • Good in 15,

  • Fair in one humerus

M.A. 13 Years. M. Achondroplasia. 8 cm. 62%

U.B. 5 Years. Achondroplasia. 7.5 cm. 80%


P aley s b one s cores

Paley’sBone Scores

  • Excellent in 22

  • Good in 5 humeri

M.G.7 Years. M. 9.5 CM .95%

N.P.7 Years. F.Achondroplaizia. 6,5 cm. 50%


Complications

Complications

  • 7 problems;

  • 2 gradeI, 2 grade II, 1 grade III pin tract infection

  • 3 radial nerve palsy spontaneously resolved

E.G. 16 Years. 6 cm . Lymphoma.33% .


Complications1

Complications

  • 3 obstacles; 3 regenerate fractures

M.G. 5 Years. M. L ulnarhemimelia. 3,7 CM .25%

M.A. 13 Years. M. Achondroplasia. 8 cm. 62%

  • No sequelae


Last word

LAST WORD

  • Unilateral external fixator provide adequate stability, low complication rate, high length amount and comfort for humeral lengthening

  • The range-of-motion of the adjacent joints arepreserved

T.K. 15 Years.M. Dwarfism.8 CM.50%


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