Surgical technique and outcomes for bilateral humeral lengthening for achondroplasia: 26-year experience

被引：13

作者：

Ginebreda I. ^{[1
]}

Campillo-Recio D. ^{[1
]}

Cárdenas C. ^{[1
]}

Tapiolas J. ^{[1
]}

Rovira P. ^{[1
]}

Isart A. ^{[1
]}

机构：

[1] ICATME, Hospital Universitari Quiron-Dexeus, Carrer Sabino de Arana, 5-19, Barcelona

来源：

MUSCULOSKELETAL SURGERY | 2019年 / 103卷 / 3期

关键词：

Achondroplasia; Humeral lengthening; Surgical technique;

D O I：

10.1007/s12306-018-0583-3

中图分类号：

学科分类号：

摘要：

Background: Elongation in patients with achondroplasia provides better overall skeletal proportionality and significantly improves such individuals’ access to their perineal region to self-manage personal hygiene. This paper describes our surgical technique and outcomes for bilateral humeral lengthening in achondroplasia patients over 26 years. Methods: Ours was a retrospective study of 55 patients with achondroplasia-related short stature, in whom bilateral humeral lengthening was performed from 1990 to 2016. We describe the surgical technique and analyze mean gain in humeral length, days using an external fixator, mean percentage of lengthening, external fixation index, type of callus, and complications. Pre- and postoperative radiographic measurements were obtained. Patients also were contacted by telephone and asked about their ability to perform peri-anal self-hygiene and about their overall satisfaction. Results: In total, 110 humeri were lengthened (28 males and 27 females) with medium elongation of 9.5 cm on the right and 9.6 cm on the left, while averaging 220 days in an external fixator. We observed 14 minor complications. There was no significant association between pin position and type of callus, and elongation most often external and in the presence of a straight callus. Before elongation, 77.1% of patients reported difficulties with perineal hygiene and 85.4% could not put their hands in their pockets. Upon completion of lengthening, 100% could perform both tasks and 94.5% were very satisfied. Conclusions: Bilateral humeral elongation yields significant improvements in patient autonomy, with a relatively low complication rate and very high patient satisfaction. © 2018, Istituto Ortopedico Rizzoli.

引用

页码：257 / 262

页数：5

共 20 条

[1]

Horton W.A., Hall J.G., Hecht J.T., Achondroplasia, Lancet Lond Engl, 370, 9582, pp. 162-172, (2007)

[2]

Kitoh H., Kitakoji T., Kurita K., Katoh M., Takamine Y., Deformities of the elbow in achondroplasia, J Bone Joint Surg Br, 84, 5, pp. 680-683, (2002)

[3]

Damsin J.P., Ghanem I., Upper limb lengthening, Hand Clin, 16, 4, pp. 685-701, (2000)

[4]

Kashiwagi N., Suzuki S., Seto Y., Futami T., Bilateral humeral lengthening in achondroplasia, Clin Orthop, 391, pp. 251-257, (2001)

[5]

Vilarrubias J.M., Ginebreda I., Fernandez-Fairen M., 500 cases of lower limb lengthening using a personal technic in achondroplasia, Acta Orthop Belg, 54, 4, pp. 384-390, (1988)

[6]

Cai G., Yang L., Saleh M., Coulton L., The effect of tibial diaphyseal lengthening on the longitudinal growth of the tibia, J Pediatr Orthop Part B, 16, 6, pp. 403-407, (2007)

[7]

Paley D., Current techniques of limb lengthening, J Pediatr Orthop, 8, 1, pp. 73-92, (1988)

[8]

Cattaneo R., Villa A., Catagni M., Tentori L., Strategies for limb lengthening in achondroplasia using the Ilizarov method–the experience of the hospital of Lecco, Italy, Basic Life Sci, 48, pp. 381-388, (1988)

[9]

Shadi M., Musielak B., Koczewski P., Janusz P., Humeral lengthening in patients with achondroplasia and in patients with post-septic shortening: comparison of procedure efficiency and safety, Int Orthop, 42, 2, pp. 419-426, (2018)

[10]

Hamanishi C., Yasuwaki Y., Kikuchi H., Tanaka S., Tamura K., Classification of the callus in limb lengthening. Radiographic study of 35 limbs, Acta Orthop Scand, 63, 4, pp. 430-433, (1992)

← 1 2 →