Distraction Lengthening of the Ulna in Radial Club Hand Using the Ilizarov Technique

Abstract

Six children with radial club hand had distraction lengthening of the ulna using the Ilizarov technique at the mean age of 10 years. The mean lengthening achieved was 4.7 cm (46% of original ulna length). Complications included nocturnal pain, pin track infection and callus fracture or delayed union. Distraction lengthening of the ulna can enhance the ability to perform normal activities of daily living, such as reaching the perineum or driving a car, but complications are extremely common. The high rate of callus fracture in this series reinforces the need for regular radiographic review during distraction and suggests that after distraction it may take more than 4 weeks for satisfactory callus consolidation before removal of the fixator.

Radius Lengthening for the Treatment of Bayne and Klug Type II and Type III Radial Longitudinal Deficiency

“…The mean period in the fixator was 136 days and the mean healing index was 53 d/cm for a single lengthening procedure. These data are similar to those reported in another series 7,8,17 investigating ulnar lengthening in radial longitudinal deficiency.…”

Distraction Lengthening of the Ulna in Children With Radial Longitudinal Deficiency

“…In some series, there was a trend toward higher nonunion rates with greater amounts of lengthening. 23 In our patients, all nonunions were associated with pin track infections that caused pin loosening, requiring pin removal and diminishing the stabilization of the developing callus. Two of these nonunions occurred in patients whose ulnas had gained more than average length.…”

Congenital Longitudinal Deficiency

“…These results are similar to those published by other investigators. 15,16 Osseous distraction lengthening is recommended for mature older children or teenagers with good family support who have realistic expectations and emotional stamina.…”