Case: Intramedullary humeral lengthening is still a very uncommon procedure to treat humeral limb length discrepancy (LLD). This approach has various advantages compared with external devices but is limited in its ability to lengthen bones because of the length of the telescopic nail. This case report describes a middle-aged patient with a short right humerus secondary to a childhood growth plate injury that was successfully lengthened with an off-label application of a tibial distracting device. Hereby, a novel treatment technique with unlocking, backwinding, and reinterlocking of the telescopic nail for extended humeral distraction was performed.
Conclusions: Extended intramedullary humeral lengthening with unlocking, backwinding, and reinterlocking of the nail is a cost-effective, minimally invasive procedure in cases of massive humeral LLD with limitations in the distraction capacity of the telescopic nail.
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