title: Progressive lengthening of short congenital forearm stump in children for prosthetic fitting.
abstract: OBJECTIVE
  The sufficient length of congenital forearm stump is essential for prosthetic fitting. In our study we reviewed the results of a series of forearm stump lengthening, observed complications and their outcomes. We evaluated possibilities of combined technique to reduce or avoid problems and complications in forearm stump lengthening.
  
  
  METHODS
  We retrospectively reviewed 18 children who have undergone forearm stump lengthening. In all patients the forearm lengthening was performed by means of Ilizarov frame. Additional flexible intramedullary nailing (FIN) was applied in two cases.
  
  
  RESULTS
  The mean lengthening gain was 4.6 cm. The planned lengthening gain was obtained in all cases. The mean healing index (HI) was 34.1 days/cm. The most reduced HI was observed in two cases of combined technique (Ilizarov frame with FIN): 25.4 and 27.0 days/cm. Considering complications and outcomes the results were classified according to Lascombes: grade I--5 cases, IIa--10 cases, IIb--2 cases, IIIa--1 case. In the long term follow-up all patients used their prostheses fixed at the forearm stump with natural function of elbow joint.
  
  
  CONCLUSIONS
  Forearm progressive lengthening in children with congenital transverse deficiency of the forearm is justified in order to facilitate prosthetic procedures and to preserve natural function of elbow joint. Sufficient lengthening can be achieved within one operation with a low rate of major complications. In our experience a repeated lengthening of forearm stump is not mandatory.
authors.affiliation: Russian Ilizarov Scientific Center for Restorative Traumatology and Orthopaedics, 6, M. Ulyanova Street, 640014, Kurgan, Russian Federation. dpopkov@mail.ru.
authors.forename: Dmitry
authors.initials: D
authors.lastname: Popkov
authors.affiliation: Russian Ilizarov Scientific Center for Restorative Traumatology and Orthopaedics, 6, M. Ulyanova Street, 640014, Kurgan, Russian Federation.
authors.forename: Arnold
authors.initials: A
authors.lastname: Popkov
mesh_terms: D001852:Bone Lengthening / Q000009:adverse effects / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005542:Forearm / Q000002:abnormalities / Q000601:surgery*; D006801:Humans; D008297:Male; D017755:Prosthesis Fitting; D012189:Retrospective Studies; D014945:Wound Healing
keywords: Congenital forearm stump lengthening