Open AccessDistraction osteogenesis of the humerus: a case of 100% humeral lengthening in a short duration without permanent complications
Author(s) -
Sheng Da Jowell Cheng,
Kenneth Pak Leung Wong
Publication year - 2019
Publication title -
bmj case reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.231
H-Index - 26
ISSN - 1757-790X
DOI - 10.1136/bcr-2018-228222
Subject(s) - medicine , humerus , distraction osteogenesis , brace , distraction , surgery , external fixator , radiography , mechanical engineering , neuroscience , engineering , biology
A 15-year-old boy with right humeral shortening underwent distraction osteogenesis with 1 mm/day lengthening. Preoperative Sauvegrain method showed skeletal maturity and lengthening did not account for future growth. Functional loading was encouraged 2 months before end of consolidation phase to hasten consolidation and fixator removal was done in the clinic without local anaesthesia at the patient's request 1 month earlier. A Sarmiento brace was made and compliance taught to the patient; however, the patient did not wear the brace and resumed body weight exercise weeks after removal of the fixator. Two months after removal of the external fixator, plain radiographs showed good recanalisation of the humeral shaft with no fracture or distortion. However, the left humerus grew and is now 1 cm longer than the right humerus. Nevertheless, the patient was satisfied with the upper limb length discrepancy.