Humeral lengthening using the Ilizarov technique.

Significant shortening of the humerus may cause cosmetic, psychologic and functional problems. From 1989 to 1993, we performed humeral lengthening using the Ilizarov technique on six patients. The indications were: 1) significant inequality (> 4-14 cm); 2) significant functional impairment; and 3) poor aesthetic appearance or related psychologic problems. THere were three females and three males, with a mean age of 17.7 years. The right humerus was affected in two patients, the left in four. Etiologies included sequelae of neonatal septic shoulder in three patients, sequelae of childhood trauma in one, malunion in one and congenital bone anomaly in one. Mean shortening of the humerus was 9.2 cm. Total average treatment time was 250 days. Mean lengthening was 8.7 cm. Complications included transient radial nerve palsy in one patient and delayed union in another. Bone grafting was performed on the patient who sustained delayed union. Fracture of the distraction site occurred after removing the Ilizarov device, and open reduction and internal fixation was performed. Functional and aesthetic status was improved in all six patients, over a minimum of 2 years follow-up. Lengthening of the humerus can be performed satisfactorily using the Ilizarov technique.