Role of hybrid monolateral fixators in managing humeral length and deformity correction

Acta Orthop. 2013 Jun;84(3):280-5. doi: 10.3109/17453674.2013.786636. Epub 2013 Mar 19.

Abstract

Background and purpose: Humeral lengthening and deformity correction are now being done increasingly for various etiologies. Monolateral external fixators have advantages over traditional Ilizarov circular fixators; they are easy to apply, they are less bulky, and they are therefore more convenient for the patient. We assessed the effectiveness of hybrid monolateral lateral fixators in humeral lengthening and deformity correction.

Methods: We retrospectively reviewed 23 patients (40 humeri) with various pathologies who underwent lengthening-with or without deformity correction using monolateral external fixator-between 2003 and 2008. Mean age at the time of the surgery was 14 (10-22) years. The mean follow-up time was 3.4 (1-7) years.

Results: The average duration of external fixator use was 8.3 (6-19) months. The mean lengthening achieved was 8.8 (4-11) cm and percentage lengthening was 49% (19-73). The healing index was 28 (13-60) days/cm. The major complications were refracture in 3 humeri and varus angulation of 2 humeri. The minor complications were superficial pin tract infection (6 segments), transient radial nerve palsy (1 segment), and elbow flexion contracture (5 segments). All complications resolved.

Interpretation: Hybrid monolateral fixators can be used for humeral lengthening and deformity correction. The advantage over circular fixators is that they are less bulky and patients can perform their day-to-day activities with the fixator in situ.

Publication types

  • Evaluation Study
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Achondroplasia / diagnostic imaging
  • Achondroplasia / surgery
  • Adolescent
  • Bone Diseases, Developmental / surgery
  • Bone Nails / adverse effects
  • Child
  • External Fixators* / adverse effects
  • Female
  • Humans
  • Humerus / abnormalities*
  • Humerus / diagnostic imaging
  • Humerus / surgery*
  • Male
  • Osteogenesis, Distraction / adverse effects
  • Osteogenesis, Distraction / instrumentation*
  • Osteogenesis, Distraction / methods
  • Osteogenesis, Distraction / rehabilitation
  • Osteomyelitis / diagnostic imaging
  • Osteomyelitis / surgery
  • Osteotomy / methods
  • Patient Satisfaction
  • Prosthesis-Related Infections / etiology
  • Radiography
  • Recovery of Function
  • Retrospective Studies
  • Treatment Outcome
  • Young Adult