Arm Lengthening Surgery

We’re going to go over what Arm Lengthening is, how it works, why people would want it, the potential complications that could be associated with arm lengthening and at the end, I’ll give my personal opinion.

1. What is arm lengthening?

Arm lengthening is what it sounds like. Lengthening your upper limbs using the same principles of distraction osteogenesis used in lengthening legs.

And the bone that’s typically lengthened is the humerus, or your upper arm bone, but in some deformity cases the forearm bones, the radius and ulna, might also need to be lengthened. 

The same lengthening methods are used in that the surgeon will use a lengthening device to distract the bone at a particular rate of mm per day then when you’re done, you just let it heal, rehab like I always preach and you should be back to it.

1. Why would people want arm lengthening

So there are 2 main reasons why a person chooses to get arm lengthening done…

1. The first is a functional reason - a lot of times, individuals with forms of dwarfism where their arms aren’t long enough to perform daily tasks, they’ll opt-to get it done so they can move their arms and hands to grab items or reach things in free space easier

1. Next up, you have the cosmetic reasons - and there are actually 2 of them

1. The first cosmetic reason being for people with an arm length discrepancy - which could also be a functional reason, but for the most part it’s for appearance because the arms are non-weight-bearing limbs and thus a discrepancy won’t hurt you since we humans are bipedal meaning we walk on our feet and not our arms, (unless you’re one of those crazy-talented-people that can walk on your hands) 

1. The second cosmetic reason is primarily for balancing limb length proportions to the body. And if you haven’t seen it yet, I did a video a while back on proportions - I’ll link it on screen now so you can go check it out, but basically I mentioned when it comes to favorable limb to body proportions, the leg to body ratio will matter more than the arm to body ratio. 
2. And if you’re planning to get cosmetic stature lengthening on the legs to get taller, you probably have thought to yourself, “well if I lengthen my legs, then what about my arms, they need to be perfectly balanced too right” - we’ll talk about this in a bit.
3. Regarding the lengthening devices used to do arm lengthening, you have the same ones as for the legs; external ring fixators, monolateral fixators and now internal lengthening nails. What’s the best? Well it depends on what need it for, but unless you have a severe deformity where you might need an external, but if for functional or cosmetic reasons, go for the internal nail, I mean it’ll be much easier to move, sleep, do rehab and less scarring.

1. Potential complications with arm lengthening 

Believe it or not, you have a lot of the same complications that could possibly occur with arm lengthening, that happens with leg lengthening. Things like muscle contractures, non-unions, infection and nerve palsies, all could technically be a problem. Based on the literature I’ve read, the most common of these “relatively-rare” complications seems to be muscle contractures and radial nerve palsy. 

And when it comes to muscles, your triceps in your arms are like the quadriceps in your legs because they both extend the lower limb and the biceps is like your hamstrings in that it flexes your lower limb. And you can reduce the chance of a muscle contracture happening by doing, guess what...that’s right - your physical therapy. I don’t preach rehab for no reason guys, it’s really that important!

What about this radial nerve thingy? Well in the upper body, you have this web-like-union of nerves called the brachial plexus that branch off into very important nerves that help you move your arms, hands and fingers. 

Well in the upper arm, the radial nerve kind of curves around a groove in the back of the humerus bone and so during the osteotomy when the surgeon is breaking the bone, it could technically be damaged if not careful. And how do you reduce the chance of this happening? That’s right...find a good and experienced surgeon…

1. My personal opinion on arm lengthening

Alright so, I think arm lengthening is fine if you have a functional issue and need to be able to reach things and do daily tasks easier. I also think if you have a discrepancy between the arms and want to balance the cosmetic appearance of them, then it’s important. 

But if you’re just doing it to have perfect proportions and look like the Vitruvian man after you get leg lengthening done, I’m not a huge fan of that. I mean, if your arms are already shorter in comparison to your legs and then you get leg lengthening...if it’s highly noticeable to an untrained eye, then yeah whatever, but if you’re going by calculations to be perfectly balanced it’s just not worth it.

So at the end of the day, you need to make the decision if it's right for you or not but just know it's a very expensive and involved procedure for a not-so-significant change if you don't need it for functional use or appearance because of a discrepancy.

This was posted on Christmas Day 2020 so I want to wish all of you reading it then a very Merry Christmas!