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Lengthening of upper limbs is an infrequent event because the surgical approach is necessary only for functional requests of single limbs and not for a different length of the limbs. The cause of short limb can be congenital or acquired postraumatic, postinfective and post tumor resection. Lengthening of both humeris is required in achondropolasic dwarves, when the shorthi est upper limbs determine a disarmony with the lower ones and when the brevity of upper limbs cause difficulties in executing normal physiological activities. Surgical therapy, now spread in the world for lower limbs, is becoming more and more applied also for upper ones. The preoperative plan should not consider the amount of the difference, the age of the patient and the prediction of future growth of the limb to operate, but only the possibility to give to the limb better functional capacities. On this basis and after a review of previous experiencies, the authors present a general planning of the current use at their department, that has to be adapted, each, to the personal requisites of patients, as for the ideal age to perform the operation as for the surgical technique to be adopted.