Abstract

Purpose: Humeral lengthening in patients with post septic shortening is a challenging procedure for Orthopaedic surgeon. The aim of this study was to evaluate the efficacy and safety of humeral lengthening using Ilizarov fixator. We reviewed the literature on humeral lengthening using different fixators with regard to indications, operative technique, results and complications. We also retrospectively reviewed 12 patients treated with humeral lengthening using Ilizarov external fixation. The etiology was epiphyseal injury (7 cases), infection (5 cases). The average age at surgery was 14,5 years (range 12,5-23,5) with post septic humeral shortening. The patients were assessed clinically and radio-graphically. Follow up ranged from 1-10-years.The magnitude of lengthening achieved ranged from 5-15cm with an average of 7, 5cm. Functionally all the patients returned to their preoperative jobs and daily activities including sports. Complications included pin track infection in 8 patients, radial nerve palsy which recovered completely in one patient. Conclusion; Humeral lengthening is a valid method that improves the outcome following arm shortening and deformity correction including angulation and rotation. Extensive lengthening up to 100% of the original length could be achieved without increasing the risk of complications.

Method: Twelve patients were included in this study with post septic shortening of the humerus. All patients underwent distraction osteogenesis with the use of an Ilizarov fixator.

Results: The mean lengthening in patients with post septic shortening was 7.5cm. The mean healing index was 24.8 days/cm in the patients with achondroplasia and 25.5 days/cm in the patients with post septic shortening.

Conclusion: Humeral lengthening with use of Ilizarov fixators in patients with post septic shortening is an efficient method.

Keywords

humeral lengthening, post septic shortening, Ilizarov fixator, upper extremity lengthening, powerful technique, less pain, twelve patients, humeri, neurologic assessment, osteotome, composer, medical personnel, nerve complications, fixator loosening, manipulation, radial nerve, treatment time