Limb lengthening
Arm lengthening (humerus)
Humerus lengthening is used both for arm-length discrepancy and for cosmetic proportion. The conventional route uses a mono-fixator, which allows 8-10 cm and lets patients use the arm for daily tasks. The institute now favours the internal PRECICE nail: smaller scars, less pain and no pin-site infection.
Who it suits
- Arm-length discrepancy from trauma, infection or congenital causes
- Achondroplasia, where extra arm reach is needed
- Patients rebalancing arm proportion after leg lengthening
Technique highlights
- The external route reaches 8-10 cm and the arm stays usable during lengthening
- The internal PRECICE route means small scars, less pain and no pin marks
Surgical steps
- Assess both arm lengths and shoulder-joint integrity.
- Choose between the external mono-fixator and the internal PRECICE nail.
- Humeral osteotomy and hardware placement.
- Lengthen on schedule with shoulder and elbow physiotherapy.
Recovery & aftercare
- In many cases the arm can be used for light daily activity during lengthening.
- Shoulder physiotherapy is critical to prevent stiffness.
Risks & things to consider
- Bone lengthening is major surgery. Outcome and recovery time depend on bone quality, age, weight and how disciplined the patient is with rehabilitation, so identical results cannot be guaranteed.
- Daily physiotherapy is mandatory through both the lengthening and consolidation phases. Skipping it risks joint stiffness, muscle contracture or delayed bone healing.
- Disclose all medical conditions, regular medication, previous bone surgery and drug allergies at the consultation, and stop smoking before and after surgery as instructed — nicotine measurably slows bone healing.
- Nail insertion into the humerus risks rotator-cuff injury or iatrogenic fracture, so it must be done by a specialised surgeon.
Frequently asked questions
How much arm length can be gained?
The external mono-fixator can achieve 8-10 cm; with the internal PRECICE nail the limit depends on bone length and soft-tissue safety, and the team confirms a safe figure at consultation.
Other procedures in this area
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