Evaluation of the ulna lengthening by distraction osteogenesis in congenital radial deficiency

• Published in: European journal of orthopaedic surgery & traumatology Vol. 33; no. 5; pp. 1981 - 1987
• Main Authors: Górecki, Michał, Redman, Marcin, Romanowski, Leszek, Czarnecki, Piotr
• Format: Journal Article
• Language: English
• Published: Paris Springer Paris 01.07.2023; Springer Nature B.V
• Subjects: Medicine; Medicine & Public Health; Original; Original Article; Patients; Surgical Orthopedics; Traumatic Surgery; Radial club hand; Ulna lengthening; Ulna elongation; Distraction osteogenesis; Congenital disorders; Radial longitudinal deficiency
• ISSN: 1432-1068; 1633-8065; 1432-1068
• DOI: 10.1007/s00590-022-03381-1

Purpose Publications evaluating the results of the ulna lengthening in congenital radial deficiency are based only on small groups of subjects which yield statistical studies of low scientific value. The aim was to examine the effectiveness of ulna lengthening in radial longitudinal deficiency and determine the number and quality of complications based on one of the most numerous study groups described in the literature. Methods The material consists of a study group with 31 upper limbs of unmatured patients diagnosed with type III and IV radial longitudinal deficiency. The study group was evaluated based on the parameters known from the literature. The difficulties during elongation were classified according to Paley’s classification. Results The study group contained patients with a mean age of 9 years, and the number of boys and girls was comparable. Ulna length significantly increased after elongation compared to the initial bone length. The patient’s age didn’t affect the ulna lengthening, and the amount of elongation didn’t significantly affect the total stabilization period. However, the total stabilization time increased with increasing patient age. Difficulties affected more than half of the cases. Conclusions Ulna elongation in congenital radial deficiency results in significant lengthening of the ulna, and thus the entire forearm, compared to the initial bone length. This technique has a high percentage of difficulty, so its use should be considered after cautious discussion with the parents and patients.