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[albate1988]

Hello there LL community,

I'm sure you've all heard that cosmetic forearm lengthening is an absolute no no. Many respectable doctors have attest to this and refuse to perform this type of surgery. The reason for which I can understand: Hands are intricate structures tasked with very detailed functions and to sabotage this mechanism is not worth the gain. However, I was wondering If this is still the case for minor amounts of lengthening. Say 3-4 cm. I know I'm going to get many backlashes for asking this, but I just want to know more about this matter. Why can't we put a safe lengthening amount on forearms as we do for other segments. i.e tibs: 5cm, femur:7 cm , humerus: 5cm.

Any feedback is appreciated.

[sphenopetroclival]

Hello there LL community,

I'm sure you've all heard that cosmetic forearm lengthening is an absolute no no. Many respectable doctors have attest to this and refuse to perform this type of surgery. The reason for which I can understand: Hands are intricate structures tasked with very detailed functions and to sabotage this mechanism is not worth the gain. However, I was wondering If this is still the case for minor amounts of lengthening. Say 3-4 cm. I know I'm going to get many backlashes for asking this, but I just want to know more about this matter. Why can't we put a safe lengthening amount on forearms as we do for other segments. i.e tibs: 5cm, femur:7 cm , humerus: 5cm.

Any feedback is appreciated.

can you share a relevant case report at which you've read that this is indeed not permissible? it's possible there could be some clinical utility at this intervention with respect to the context of very specific complex orthopedic cases; but I'm not an ortho bro so wouldn't know.

[junior006]

ulna and radius twist around each other supinating and pronating. unless someone can invent a nail + mechanism that allows free rotation it'll never happen for cosmetic reasons. not to mention the medullary canal of the ulna is 4-5mm which is narrower than any nail on the market (precice 2.2 smallest offering is 8.5mm)

[NailedLegs]

ulna and radius twist around each other supinating and pronating. unless someone can invent a nail + mechanism that allows free rotation it'll never happen for cosmetic reasons. not to mention the medullary canal of the ulna is 4-5mm which is narrower than any nail on the market (precice 2.2 smallest offering is 8.5mm)

Wouldn't this be similar to the Tibia and Fibula lengthening, though? No rod is implanted into the fibula. Granted, it doesn't twist like the ulna and radius do which could really increase the complexity...but I wonder what Dr's typically do for trauma patients IE a car crash. Perhaps a ilizarov type technique, but done on the forearm?

[KiloKAHN]

"In the forearm, there are some special considerations. Stability of the elbow usually is not a concern in forearm lengthening. Stability of the wrist is important, especially with radial lengthening. With ulnar lengthening, a wire through the proximal radius is needed to prevent distal migration of the radius. When performing radial lengthening alone, there is no need to fix the ulna. Flexion contracture of the elbow, wrist, and fingers tends to develop with radial lengthening and with one-bone forearm lengthening. This should be countered by vigorous physiotherapy and extension splints. Due to the small diameter of the forearm bones, large lengthenings tend to narrow the diameter of the regenerate bone formation because of the pinch of the surrounding muscles. Inevitably, this leads to the 'pulled-taffy effect' (narrowing of the center as the ends are stretched). The rate of 1 mm/day may need to be reduced to .75, .50, or .25 rom per day. Axial deviation usually is not a problem with the radius, since the ulna acts as support to it. Proximal ulnar corticotomies tend to go into flexion, especially in one-bone forearms. This should be recognized and corrected."

http://www.limblengtheningforum.com/index.php?topic=4633.msg72806#msg72806

The scary sounding part is the "pulled taffy" effect where the bone regenerate of the forearm grows more thin than the original bone due to the pinch of the surrounding muscles and small diameter of the bones in the forearm. I don't know what the practical effects of that is, but it sounds like your forearms after lengthening would forever be more brittle and prone to injury.

[oklama]

I have seen no evidence that forearm lengthening is in anyway a good idea and even direct word from assayag that it is unsafe