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

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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  1. Results of Humeral Lengthening With Unilateral External Fixator

  2. Short Humerus • Spinal flexibility decreases by aging that cause limitation of upper limb function • self service • personal and perineal hygiene • Cosmetic Psychologic Functional problems.

  3. 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

  4. 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

  5. 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%

  6. 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%

  7. 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%

  8. 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%

  9. 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%

  10. CirculairTypeFixators

  11. U.E.F.

  12. 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%

  13. 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%

  14. 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% .

  15. 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

  16. 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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