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Bilateral Humeral Lengthening

Most people undergoing lower limb stature lengthening do not choose to also lengthen their arms. For most lengthenings under 4 inches the arms do not look out of proportion. The greater the amount of lower limb lengthening the more proportionately short the arms appear especially when walking and swinging the arms by the sides. Therefore some patients who undergo longer lengthenings also choose to lengthen both humeri (upper arms). The humerus can safely be lengthened between 5-8cm. Most people choose to have 5cm of lengthening. This lengthening can be done with the Precice nail instead of the STRYDE since the arms are not normally used for weightbearing. There are more diameter and size options with the Precice than with the STRYDE.

Forearm lengthening is not an option. The forearm contains two long bones. These two bones have a very delicate anatomic relationship to each other. The radius bone rotates around the ulna bone. This motion is called supination (palm up) and pronation (palm down). Forearm rotation is a very important function. Lengthening of the forearm causes loss of pronation and supination range. Therefore lengthening of the radius and ulna would cause significant loss of upper extremity function. This tradeoff is not reasonable and therefore should never be done when normal anatomy and motion exists before surgery.

We also do not lengthen the feet, hands, fingers or toes. We do not lengthen the clavicles (collar bones). It is not that these bones cannot be lengthened. It is that lengthening these bones causes serious permanent loss of function which is not an acceptable trade off for making a bone longer.

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