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Humeral lengthening and proximal deformity correction with monorail external fixator in young adults

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Abstract

Purpose

Several humeral lengthening or simultaneous deformity corrections through one osteotomy using various external fixators were reported, while literature regarding correction of shortening and proximal varus deformity is scarce. This retrospective clinical study evaluated the results of preforming an acute correction and delayed lengthening in young adults through two osteotomies using monorail external fixator.

Methods

We report seven patients with various pathologies who underwent humeral proximal deformity correction and lengthening between 2009 and 2015. Pre-operative and post-operative clinical and radiographic data were collected. The mean follow-up time was 33.4 months (25–46 months).

Results

The humeral neck-shaft angle improved from 97.9° (85–110°) to 138.6° (135–145°). The magnitude of lengthening achieved was average 7.6 cm (range, 6–10 cm) at an average healing index of lengthening of 30.2 days/cm (range, 27.7–35.4 days/cm). There was a significant increase in range of shoulder abduction, and active abduction improved from pre-operative 136.4° (range, 95–160°) to post-operative 166.4° (range, 150–180°). The DASH score improved significance from 23.29 ± 8.36 to 6.57 ± 3.65 (t = 4.848; p < 0.001).

Conclusion

Acute deformity correction and gradual lengthening with the monorail external fixator can be used for humeral shortening and proximal varus angular deformity. Functional improvement is expected after surgery and post-operative therapy.

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Acknowledgements

The authors thank Zhongyu Li and Emily Cushine Schaheen for their assistance and helpful suggestions for this work.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Shanghai 6th Peoples Hospital Affiliated to Shanghai Jiaotong University School of Medicine, 600 Yishan Road, Shanghai, 200233, China

    Hongjiang Ruan, Yi Zhu, Shen Liu & Qinglin Kang

Authors
  1. Hongjiang Ruan
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  2. Yi Zhu
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  3. Shen Liu
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  4. Qinglin Kang
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Corresponding author

Correspondence to Qinglin Kang.

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On behalf of all authors, the corresponding author states that there is no conflict of interest.

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Ruan, H., Zhu, Y., Liu, S. et al. Humeral lengthening and proximal deformity correction with monorail external fixator in young adults. International Orthopaedics (SICOT) 42, 1107–1111 (2018). https://doi.org/10.1007/s00264-017-3688-7

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  • DOI: https://doi.org/10.1007/s00264-017-3688-7

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