Acta Orthop Traumatol Turc
Correction of deformities and length discrepancies of the forearm in children by distraction osteogenesis
Abstract
Objectives: To review the results of correction of deformities and length discrepancies of the forearm in children.
Methods: We evaluated the results of distraction osteogenesis in 10 forearms of nine patients with forearm shortening and/or deformity. The mean age at the time of surgery was 10.2 years (range 5 to 16 years). Etiologies included congenital radioulnar synostosis and preaxial longitudinal deficiency of the forearm (n=1), congenital radioulnar synostosis and shortening of the forearm (n=1), multiple hereditary osteochondromas (n=1), distal radial physeal arrest (n=1), Madelung’s deformity (n=2), bilateral congenital forearm shortening due to postaxial acrofacial dysostosis syndrome (n=1), and defect nonunion of the radius alone (n=1) and with the ulna (n=1) with shortening. Ilizarov type circular external fixators and monoplanar Orthofix fixators were used in seven and three patients, respectively. The mean follow-up was four years and four months (range 1 to 9 years).
Results: The mean length gain was 36.7 mm (range 25 to 60 mm), which meant a mean increase by 31.5% (range %14 to 66%). A satisfactory functional and cosmetic improvement was achieved in all patients. Bone consolidation occurred in three to 13 months without a need for bone grafting. The most common complication was callus deformity seen after the removal of the fixator.
Conclusion: Lengthening of the forearm results in improved upper extremity function, especially in activities requiring equal arm length as well as better cosmetic appearance if adequate soft tissue is preserved.
Methods: We evaluated the results of distraction osteogenesis in 10 forearms of nine patients with forearm shortening and/or deformity. The mean age at the time of surgery was 10.2 years (range 5 to 16 years). Etiologies included congenital radioulnar synostosis and preaxial longitudinal deficiency of the forearm (n=1), congenital radioulnar synostosis and shortening of the forearm (n=1), multiple hereditary osteochondromas (n=1), distal radial physeal arrest (n=1), Madelung’s deformity (n=2), bilateral congenital forearm shortening due to postaxial acrofacial dysostosis syndrome (n=1), and defect nonunion of the radius alone (n=1) and with the ulna (n=1) with shortening. Ilizarov type circular external fixators and monoplanar Orthofix fixators were used in seven and three patients, respectively. The mean follow-up was four years and four months (range 1 to 9 years).
Results: The mean length gain was 36.7 mm (range 25 to 60 mm), which meant a mean increase by 31.5% (range %14 to 66%). A satisfactory functional and cosmetic improvement was achieved in all patients. Bone consolidation occurred in three to 13 months without a need for bone grafting. The most common complication was callus deformity seen after the removal of the fixator.
Conclusion: Lengthening of the forearm results in improved upper extremity function, especially in activities requiring equal arm length as well as better cosmetic appearance if adequate soft tissue is preserved.