Bone Lengthening in the Pediatric Upper Extremity

J Bone Joint Surg Am. 2016 Sep 7;98(17):1490-503. doi: 10.2106/JBJS.16.00007.


➤Bone lengthening has been used successfully for several congenital and acquired conditions in the pediatric clavicle, humerus, radius, ulna, and phalanges.➤Common indications for bone lengthening include achondroplasia, radial longitudinal deficiency, multiple hereditary exostosis, brachymetacarpia, symbrachydactyly, and posttraumatic and postinfectious growth arrest.➤Most authors prefer distraction rates of <1 mm/day for each bone in the upper extremity except the humerus, which can safely be lengthened by 1 mm/day.➤Most authors define success by the amount of radiographic bone lengthening, joint motion after lengthening, and subjective patient satisfaction rather than validated patient-related outcome measures.➤Bone lengthening of the upper extremity is associated with a high complication rate, with complications including pin-track infections, fixation device failure, nerve lesions, nonunion, fracture of regenerate bone, and joint dislocations.

Publication types

  • Review

MeSH terms

  • Adolescent
  • Bone Lengthening / instrumentation
  • Bone Lengthening / methods*
  • Child
  • Humans
  • Humerus / surgery
  • Osteogenesis, Distraction / instrumentation
  • Osteogenesis, Distraction / methods
  • Radius / surgery
  • Treatment Outcome
  • Ulna / surgery
  • Upper Extremity / surgery*