[Correction of deformities and length discrepancies of the forearm in children by distraction osteogenesis].
OBJECTIVE
To review the results of correction of deformities and length discrepancies of the forearm in children.


METHODS
We evaluated the results of distraction osteogenesis in 10 forearms of nine patients with forearm shortening and/or deformity. The mean age at the time of surgery was 10.2 years (range 5 to 16 years). Etiologies included congenital radioulnar synostosis and preaxial longitudinal deficiency of the forearm (n=1), congenital radioulnar synostosis and shortening of the forearm (n=1), multiple hereditary osteochondromas (n=1), distal radial physeal arrest (n=1), Madelung's deformity (n=2), bilateral congenital forearm shortening due to postaxial acrofacial dysostosis syndrome (n=1), and defect nonunion of the radius alone (n=1) and with the ulna (n=1) with shortening. Ilizarov type circular external fixators and monoplanar Orthofix fixators were used in seven and three patients, respectively. The mean follow-up was four years and four months (range 1 to 9 years).


RESULTS
The mean length gain was 36.7 mm (range 25 to 60 mm), which meant a mean increase by 31.5% (range 14% to 66%). A satisfactory functional and cosmetic improvement was achieved in all patients. Bone consolidation occurred in three to 13 months without a need for bone grafting. The most common complication was callus deformity seen after the removal of the fixator.


CONCLUSIONS
Lengthening of the forearm results in improved upper extremity function, especially in activities requiring equal arm length as well as better cosmetic appearance if adequate soft tissue is preserved.
Bagatur
A Erdem
AE
Department of Orthopedics and Traumatology (1. Ortopedi ve Travmatoloji Kliniği), SSK Istanbul Training Hospital, 34098 Istanbul, Turkey. bagatur@ixir.com
Doğan
Ahmet
A
Zorer
Gazi
G
D000293:Adolescent; D001852:Bone Lengthening / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D016267:External Fixators; D005260:Female; D005500:Follow-Up Studies; D005542:Forearm / Q000002:abnormalities / Q000601:surgery; D006801:Humans; D018889:Ilizarov Technique; D008297:Male; D019857:Osteogenesis, Distraction / Q000379:methods; D011859:Radiography; D011884:Radius / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome; D014421:Turkey; D014457:Ulna / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery*