Bone-Graft Operations to Lengthen the Humerus in Short Arm Amputation Stumps

Report of the Results in Two Bilateral Above-the-Elbow Amputees

¹ Division of Orthopaedics, Department of Surgery, University of California, and Wadsworth Hospital, United States Veterans Administration Center, Los Angeles

1. Two patients with high above-the-elbow arm amputation stumps, too short for function, had large areas of soft tissue hanging below tile bone ends. Massive autogenous-bone grafts were imlplanted to elongate the humerus, produce internal rigidity in the end of the stump, and increase the length of the lever arm that could activate a prosthesis.

2. When the graft extended into the subcutaneous space, under moving skin and soft parts, it caused persistent inflammation, fibrinoid degeneration, and painful bursitis. When the graft was shortened to a position deeply recessed in muscle, it was well tolerated and capable of a limited form of function in the use of an artificial limb.

3. The donor tissue was replaced by new bone from the host along a distance of only approximately one centimeter. Beyond this point, on the basis of its roentgenographic characteristics, the bone graft appeared to remain inert and either unreplaced on slowly resorbed.

4. This procedure is of limited value and can be recommended only for unusual stumps having a lange muscle mass in which to bury the transplant.

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