[Humeral lengthening after replantation of the upper limb]. 1994

X Pascarel, and J M Peres, and G Le Clouerec
Service d'Orthopédie-Traumatologie, Hôpital Pellegrin Tripode, Bordeaux.

BACKGROUND The authors have applied the method of progressive lengthening to correct upper limb discrepancy resulting from arm reimplantation in a young female adult. METHODS Following a motor vehicle accident, a twenty one years old female had her right arm sectioned. Four hours after the accident, the limb was reimplanted with 10 cm shortening of the humeral shaft, to allow direct nerve suture. Sixteen months later, she had excellent functional recovery, but was annoyed by the aesthetic appearance of her short arm. Humeral lengthening was undertaken. METHODS The authors used a special external fixation device Orthofix (Verona, Italy) and a proximal corticotomy was performed. RESULTS Progressive callus distraction allowed 10 cm lengthening without any loss of function in 10 months; aesthetic appearance was greatly improved. CONCLUSIONS Limb reimplantation necessitates substantial bone shortening to protect soft tissue sutures. Functional recovery and aesthetic tolerance are classically good but in this case, aesthetic tolerance was poor. The progressive humeral lengthening was uneventful and allowed excellent outcome, in this young girl, despite distraction of the sutured nerve. CONCLUSIONS This technique should be used prudently.

UI MeSH Term Description Entries
D012092 Replantation Restoration of an organ or other structure to its original site. Reimplantation,Surgical Replantation,Replantation, Surgical,Reimplantations,Replantations,Replantations, Surgical,Surgical Replantations
D001852 Bone Lengthening Increase in the longest dimension of a bone to correct anatomical deficiencies, congenital, traumatic, or as a result of disease. The lengthening is not restricted to long bones. The usual surgical methods are internal fixation and distraction. Lengthening, Bone
D004630 Emergencies Situations or conditions requiring immediate intervention to avoid serious adverse results. Emergency
D005260 Female Females
D005500 Follow-Up Studies Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease. Followup Studies,Follow Up Studies,Follow-Up Study,Followup Study,Studies, Follow-Up,Studies, Followup,Study, Follow-Up,Study, Followup
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D006810 Humeral Fractures Fractures of the HUMERUS. Humeri Fractures,Humerus Fractures,Fracture, Humeral,Fracture, Humeri,Fracture, Humerus,Humeral Fracture,Humeri Fracture,Humerus Fracture
D000063 Accidents, Traffic Accidents on streets, roads, and highways involving drivers, passengers, pedestrians, or vehicles. Traffic accidents refer to AUTOMOBILES (passenger cars, buses, and trucks), BICYCLING, and MOTORCYCLES but not OFF-ROAD MOTOR VEHICLES; RAILROADS nor snowmobiles. Traffic Collisions,Traffic Crashes,Traffic Accidents,Accident, Traffic,Collision, Traffic,Collisions, Traffic,Crashes, Traffic,Traffic Accident,Traffic Collision
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D000673 Amputation, Traumatic Loss of a limb or other bodily appendage by accidental injury. Amputations, Traumatic,Traumatic Amputation,Traumatic Amputations

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