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Bone lengthening surgery saves Calgary boy from disability

CALGARY- 11-year-old Gavin Dunbar loves to play hockey. He’s  been a goalie since he was 8, but last year a rare bone condition forced him off the ice.

“Imagine golf balls and peas and tennis balls under your skin,” Dunbar explains, as he describes living with Multiple Hereditary Exostoses. MHE is a rare bone condition that causes bumps to form on bones throughout the body. While the disease only impacts 1 in 50,000 people, his mother and sister also have the condition.

“The bumps themselves are not so much a problem, what tends to cause the issue in children or even in adults is if [the bumps] are causing deformity,” explains Dr. Carmen Brauer, an orthopediatric surgeon with the Alberta Children’s Hospital.
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A bump near Dunbar’s wrist was doing just that. The forearm is made up of two bones, the ulna and the radius. The bones run parallel and should be about the same length, but a lesion on Dunbar’s ulna meant that bone had become shorter. It was causing his arm to bow and without surgery, his elbow would likely dislocate. To save him from permanent disability, doctors needed to lengthen the bone.

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“Bone lengthening in the upper extremity is fairly rare compared to the lower extremity, and here at the Alberta Children’s Hospital we hadn’t done any lengthening of the upper extremity,” Dr. Brauer says.

A team was assembled to perform the first procedure on Dunbar last June. His bone was cut and a device was implanted to apply tension over time to help the bone to grow.

“We slowly distract and the bone then heals under the tension we’re applying. By doing that we can lengthen the bone up to a millimeter a day,” Dr. Brauer explains.

Between June and August, Gavin slowly increased the device’s tension to help his bone and soft tissues grow. His ulna has grown the necessary four centimetres and by late November, doctors expect to be able to remove the device.

“Now we’re just waiting for the bone to heal and get nice and solid,” Dunbar’s mother Brenda says. “Then he can go back to all the things he loves to do.”

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Gavin already has big plans.

“I want to go paint balling, play hockey and go swimming.”

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