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Erschienen in: International Orthopaedics 2/2018

09.09.2017 | Original Paper

Humeral lengthening in patients with achondroplasia and in patients with post-septic shortening: comparison of procedure efficiency and safety

verfasst von: Milud Shadi, Bartosz Musielak, Paweł Koczewski, Piotr Janusz

Erschienen in: International Orthopaedics | Ausgabe 2/2018

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Abstract

Purpose

Although humeral lengthening in patients with achondroplasia is an accepted procedure for improving functional status, there is still a paucity of information about the effectiveness of the method. Therefore, the aim of this study was to evaluate the efficacy and safety of humeral lengthening using monolateral fixators in patients with achondroplasia and unilateral shortening.

Methods

Twenty-one patients (31 humeri) were included in this study. The study group consisted of eight patients with achondroplasia (16 segments). The control group consisted of 13 patients with post-septic shortening of the humerus (15 segments). All subjects underwent distraction osteogenesis with the use of a monolateral fixator.

Results

The mean lengthening in the patients with achondroplasia was 8.29 cm, whereas in the control group it was 7.34 cm (p = 0.1677). The mean lengthening percentage in the patients with achondroplasia (50% of the initial length of the humerus) was significantly greater than in the control group (33% of the initial length of the humerus) (p = 0.0007). The mean healing index was 24.8 days/cm in the patients with achondroplasia and 28.56 days/cm in the control group (p = 0.1832). The overall complication rates for the achondroplastic and post-septic patients were, respectively, 175% and 160% (p = 0.1420).

Conclusions

Humeral lengthening with use of monolateral fixators in patients with achondroplasia is an efficient method. Although the segment lengthening percentage is significantly greater in patients with achondroplasia than in patients with post-septic shortening of the humerus, the safety of this procedure is comparable.
Literatur
1.
Zurück zum Zitat Bellus GA, Hefferon TW, Ortiz de Luna RI, Hecht JT, Horton WA, Machado M, Kaitila I, McIntosh I, Francomano CA (1995) Achondroplasia is defined by recurrent G380R mutations of FGFR3. Am J Hum Genet 56:368–373PubMedPubMedCentral Bellus GA, Hefferon TW, Ortiz de Luna RI, Hecht JT, Horton WA, Machado M, Kaitila I, McIntosh I, Francomano CA (1995) Achondroplasia is defined by recurrent G380R mutations of FGFR3. Am J Hum Genet 56:368–373PubMedPubMedCentral
2.
Zurück zum Zitat Balci HI, Kocaoglu M, Sen C, Eralp L, Batibay SG, Bilsel K (2015) Bilateral humeral lengthening in achondroplasia with unilateral external fixators: is it safe and does it improve daily life? Bone Joint J 97-B:1577–1581CrossRefPubMed Balci HI, Kocaoglu M, Sen C, Eralp L, Batibay SG, Bilsel K (2015) Bilateral humeral lengthening in achondroplasia with unilateral external fixators: is it safe and does it improve daily life? Bone Joint J 97-B:1577–1581CrossRefPubMed
3.
Zurück zum Zitat Kim SJ, Agashe MV, Song SH, Choi HJ, Lee H, Song HR (2012) Comparison between upper and lower limb lengthening in patients with achondroplasia: a retrospective study. J Bone Joint Surg Br. 94(1):128–133CrossRefPubMed Kim SJ, Agashe MV, Song SH, Choi HJ, Lee H, Song HR (2012) Comparison between upper and lower limb lengthening in patients with achondroplasia: a retrospective study. J Bone Joint Surg Br. 94(1):128–133CrossRefPubMed
4.
Zurück zum Zitat Pawar AY, McCoy TH Jr, Fragomen AT, Rozbruch SR (2013) Does humeral lengthening with a monolateral frame improve function? Clin Orthop Relat Res 471:277–283CrossRefPubMed Pawar AY, McCoy TH Jr, Fragomen AT, Rozbruch SR (2013) Does humeral lengthening with a monolateral frame improve function? Clin Orthop Relat Res 471:277–283CrossRefPubMed
5.
Zurück zum Zitat Cattaneo R, Catagni MA, Guerreschi F (1993) Applications of the Ilizarov method in the humerus. Lengthenings and nonunions. Hand Clin 9:729–739PubMed Cattaneo R, Catagni MA, Guerreschi F (1993) Applications of the Ilizarov method in the humerus. Lengthenings and nonunions. Hand Clin 9:729–739PubMed
6.
Zurück zum Zitat Kashiwagi N, Suzuki S, Seto Y, Futami T (2001) Bilateral humeral lengthening in achondroplasia. Clin Orthop Relat Res 391:251–257CrossRef Kashiwagi N, Suzuki S, Seto Y, Futami T (2001) Bilateral humeral lengthening in achondroplasia. Clin Orthop Relat Res 391:251–257CrossRef
7.
Zurück zum Zitat Cattaneo R, Villa A, Catagni MA, Bell D (1990) Lengthening of the humerus using the Ilizarov technique. Description of the method and report of 43 cases. Clin Orthop Relat Res 250:117–124 Cattaneo R, Villa A, Catagni MA, Bell D (1990) Lengthening of the humerus using the Ilizarov technique. Description of the method and report of 43 cases. Clin Orthop Relat Res 250:117–124
8.
Zurück zum Zitat Marangoz S, Herzenberg J, Paley D, Rovetta L, Standard S. (2010) Bilateral humeral lengthening in patients with achondroplasia. J Bone Joint Surg Br 92-B(SUPP IV):597. Marangoz S, Herzenberg J, Paley D, Rovetta L, Standard S. (2010) Bilateral humeral lengthening in patients with achondroplasia. J Bone Joint Surg Br 92-B(SUPP IV):597.
9.
Zurück zum Zitat McLawhorn AS, Sherman SL, Blyakher A, Widmann RF (2011) Humeral lengthening and deformity correction with the multiaxial correction system. J Pediatr Orthop B 20:111–116CrossRefPubMed McLawhorn AS, Sherman SL, Blyakher A, Widmann RF (2011) Humeral lengthening and deformity correction with the multiaxial correction system. J Pediatr Orthop B 20:111–116CrossRefPubMed
10.
Zurück zum Zitat Malot R, Park KW, Song SH, Kwon HN, Song HR (2013) Role of hybrid monolateral fixators in managing humeral length and deformity correction. Acta Orthop 84:280–285CrossRefPubMedPubMedCentral Malot R, Park KW, Song SH, Kwon HN, Song HR (2013) Role of hybrid monolateral fixators in managing humeral length and deformity correction. Acta Orthop 84:280–285CrossRefPubMedPubMedCentral
11.
Zurück zum Zitat Kato H, Minami A, Suenaga N, Iwasaki M, Kimura T (2002) Callotasis lengthening in patients with brachymetacarpia. J Pediatr Orthop 22:497–500PubMed Kato H, Minami A, Suenaga N, Iwasaki M, Kimura T (2002) Callotasis lengthening in patients with brachymetacarpia. J Pediatr Orthop 22:497–500PubMed
12.
Zurück zum Zitat Akman SD, KarakaŞ P, Bozkir G (2006) The morphometric measurements of humerus segments. Turk J Med Sci 36:81–85 Akman SD, KarakaŞ P, Bozkir G (2006) The morphometric measurements of humerus segments. Turk J Med Sci 36:81–85
13.
Zurück zum Zitat Paley D (1990) Problems obstacles and complications of limb lengthening by the Ilizarov technique. Clin Orthop Relat Res 250:81–104 Paley D (1990) Problems obstacles and complications of limb lengthening by the Ilizarov technique. Clin Orthop Relat Res 250:81–104
14.
Zurück zum Zitat Cattaneo R, Villa A, Catagni M, Tentori L (1988) Limb lengthening in achondroplasia by Ilizarov’s method. Int Orthop 12:173–179CrossRefPubMed Cattaneo R, Villa A, Catagni M, Tentori L (1988) Limb lengthening in achondroplasia by Ilizarov’s method. Int Orthop 12:173–179CrossRefPubMed
15.
Zurück zum Zitat Zinn SL (1990) Body size and habitus. In Walker HK, Hall WD, Hurst JW (eds.) Clinical methods: the history, physical, and laboratory examinations, 3rd edn. Butterworths, Boston Zinn SL (1990) Body size and habitus. In Walker HK, Hall WD, Hurst JW (eds.) Clinical methods: the history, physical, and laboratory examinations, 3rd edn. Butterworths, Boston
16.
Zurück zum Zitat De Bastiani G, Aldegheri R, Renzi-Brivio L, Trivella G (1987) Limb lengthening by callus distraction (callotasis). J Pediatr Orthop 7:129–134CrossRefPubMed De Bastiani G, Aldegheri R, Renzi-Brivio L, Trivella G (1987) Limb lengthening by callus distraction (callotasis). J Pediatr Orthop 7:129–134CrossRefPubMed
17.
Zurück zum Zitat Tanaka K, Nakamura K, Matsushita T, Horinaka S, Kusaba I, Kurokawa T (1998) Callus formation in the humerus compared with the femur and tibia during limb lengthening. Arch Orthop Trauma Surg 117:262–264CrossRefPubMed Tanaka K, Nakamura K, Matsushita T, Horinaka S, Kusaba I, Kurokawa T (1998) Callus formation in the humerus compared with the femur and tibia during limb lengthening. Arch Orthop Trauma Surg 117:262–264CrossRefPubMed
19.
Zurück zum Zitat Yasui N, Kawabata H, Kojimoto H, Ohno H, Matsuda S, Araki N, Shimomura Y, Ochi T (1997) Lengthening of the lower limbs in patients with achondroplasia and hypochondroplasia. Clin Orthop Relat Res. 344:298–306CrossRef Yasui N, Kawabata H, Kojimoto H, Ohno H, Matsuda S, Araki N, Shimomura Y, Ochi T (1997) Lengthening of the lower limbs in patients with achondroplasia and hypochondroplasia. Clin Orthop Relat Res. 344:298–306CrossRef
20.
21.
Zurück zum Zitat Kiss S, Pap K, Vízkelety T, Terebessy T, Balla M, Szoke G (2008) The humerus is the best place for bone lengthening. Int Orthop 32:385–388CrossRefPubMed Kiss S, Pap K, Vízkelety T, Terebessy T, Balla M, Szoke G (2008) The humerus is the best place for bone lengthening. Int Orthop 32:385–388CrossRefPubMed
22.
Zurück zum Zitat Hosny GA (2005) Unilateral humeral lengthening in children and adolescents. J Pediatr Orthop B 14:439–443CrossRefPubMed Hosny GA (2005) Unilateral humeral lengthening in children and adolescents. J Pediatr Orthop B 14:439–443CrossRefPubMed
23.
Zurück zum Zitat Clement H, Pichler W, Tesch NP, Heidari N, Grechenig W (2010) Anatomical basis of the risk of radial nerve injury related to the technique of external fixation applied to the distal humerus. Surg Radiol Anat 32:221–224CrossRefPubMed Clement H, Pichler W, Tesch NP, Heidari N, Grechenig W (2010) Anatomical basis of the risk of radial nerve injury related to the technique of external fixation applied to the distal humerus. Surg Radiol Anat 32:221–224CrossRefPubMed
24.
Zurück zum Zitat Katz K, Goldberg I, Bahar A, Yosipovitch Z (1989) Humeral lengthening for septic neonatal growth arrest. J Hand Surg Am 14:903–907CrossRefPubMed Katz K, Goldberg I, Bahar A, Yosipovitch Z (1989) Humeral lengthening for septic neonatal growth arrest. J Hand Surg Am 14:903–907CrossRefPubMed
Metadaten
Titel
Humeral lengthening in patients with achondroplasia and in patients with post-septic shortening: comparison of procedure efficiency and safety
verfasst von
Milud Shadi
Bartosz Musielak
Paweł Koczewski
Piotr Janusz
Publikationsdatum
09.09.2017
Verlag
Springer Berlin Heidelberg
Erschienen in
International Orthopaedics / Ausgabe 2/2018
Print ISSN: 0341-2695
Elektronische ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-017-3632-x

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