Forearm post-traumatic deformities: Classification and treatment

Massobrio, M; Pellicanò, Giovanni Francesco; Albanese, Patricia; Antonietti, Giorgio

doi:10.1016/j.injury.2013.09.020

Cited by 6 publications

(5 citation statements)

References 12 publications

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“…The pathogenesis of this deformity is still not clearly understood. However, 4 hypotheses have been known for a long time that explains the pathophysiology of the deformity [8] , [9] , [10] , [11] , [20] , [21] , [22] .…”

Section: Discussionmentioning

confidence: 99%

Reconstruction using monorail fixator for forearm osteochondroma Masada type I and IIb: A case series

Kumara

Idulhaq

Satriadi

et al. 2021

International Journal of Surgery Case Reports

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Introduction Osteochondroma (solitary) and multiple hereditary exostoses (plural) are defined as a cartilage-capped bony projection arising on the external surface of bone containing a marrow cavity that is continuous with that of the underlying bone. These tumors grow slowly and develop to cause symptoms such as limited range of motion, joint pain, lumps, and deformities. The use of ulnar distraction osteogenesis has gained popularity in treating deformity in forearm osteochondroma. Problems that arise including bone angulation and persistent radial head dislocation. Case presentation We describe eight cases of forearm osteochondroma that came to the Prof. Dr. R. Soeharso Orthopedic Hospital, Surakarta, Indonesia. We found two variations in the classification of Masada in these 8 patients, Masada type I and IIB. The main complaint was a bent arm. We decided to do surgery in the form of tumor resection and reconstruction of the deformity by using ulnar gradual lengthening and osteotomies. The results of the procedure were investigated in this study, using clinical and radiological parameters focusing on medium-term functional and structural outcomes. Discussion and conclusion Eight patients had overall good results, although performed with a different sequence of operating techniques. Ulnar lengthening with a monorail fixator is still the main choice in its implementation. Gradual ulnar lengthening improves not only the deformity but also the functionality of the associated forearm.

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Section: Discussionmentioning

confidence: 99%

Reconstruction using monorail fixator for forearm osteochondroma Masada type I and IIb: A case series

Kumara

Idulhaq

Satriadi

et al. 2021

International Journal of Surgery Case Reports

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“…However, there have been several hypotheses to explain this situation. The forearm deformity which was caused by shortening of the ulnar relative to the radius in patients with multiple hereditary exostosis was related to four factors (Rodgers et al, 1993;Schmale et al, 1994;Stanton et al, 1996;Massobrio et al, 2014).…”

Section: Discussionmentioning

confidence: 99%

Multiple Hereditary Exostosis of Distal Ulna with Dislocation of Radial Head: A Case Report

2020

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Background: Multiple hereditary exostosis of the forearm is typically formed in the distal ulna causing disturbances in the growth of the ulna and functional disability. Multiple hereditary exostosis inhibits the growth of the ulna leading to an acquisition of a varus deformity in the radius which sometimes leads to dislocation of the radial head, the development of limitations in the pronation-supination of the forearm, and cosmetic problems. The purpose of this study was to reported the multiple hereditary exostosis of distal ulna with dislocation of radial head. Case Presentation: We present a case of a 14 year-old girl with main complaint of a bony prominence on her right elbow which limits the elbow flexion range of motion. 3D CT-Scan revealed a dislocation of radial head, shortening and posterior bowing of ulna. We performed excision of the prominent radial head, reconstruction, and temporary arthrodesis of the elbow. Results: The forearm deformity in patients with multiple hereditary exostosis related to the crosssectional area of the distal ulnar physis was only one-quarter of the distal radius, the distal ulna is more involved in the condition. There was more longitudinal growth at the distal ulnar physis than at the distal radial physis, the distal ulnar physis contributed more to total Ulnar Length than the distal radial physis did to Radial length. Known surgical interventions including simple excision, ulnar lengthening, corrective radial osteotomy, hemi-epiphyseal stapling of the distal radius, the Sauve-Kapandji procedure. Conclusion: Simple excision could improve the range of movement of the forearm but would not halt the progression of disease, particularly in younger patients. It was not effective in controlling progression of the deformity. Mature patients did not recur, but in patients that had been excised before puberty the results were varied and unpredictable.

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“…The biggest challenge in conservative treatment is to keep the fracture on the adequate axis. Plaster, together with the initial setting of bone fragments, plays a leading role [7,11]. In addition, the risk of wound infection is an important factor.…”

Section: Avoiding Complicationsmentioning

confidence: 99%

“…Moreover, deformities occurring as a complication of treatment primarily affect the shaft and distal part of the radius, and they rarely affect the ulna. This results in a limitation of the range of hand motion [7].…”

Section: Introductionmentioning

confidence: 99%

Forearm fractures in children – follow-up study of 137 cases. Comparison and statistical analysis of surgical and conservative treatment

Sojka¹,

Leonik²,

Grabowski³

2022

fmpcr

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Background. Upper limb fractures are a common issue in paediatric patients. Among the available methods, the most prevailing treatment is still closed reduction. The purpose of this study is to determine the best possible course of action in paediatric patients who sustained a forearm fracture.Objectives. The aim is to evaluate the treatment results of patients with forearm fractures treated in one paediatric surgery centre in Poland. Material and methods. 137 cases of forearm fractures were divided into groups according to the undertaken procedure and then compared using tools of statistical analysis. Several factors were analysed, with particular emphasis on the control of complications, exposure to ionising radiation, the nuisance of therapy and compliance with therapeutic recommendations. Results. The comparison resulted in a statistically significant difference in reduction of X-ray pictures and a failure rate in favour of surgical treatment. Treatment time was significantly longer for surgical procedures than for conservative treatment. A higher failure rate was reported in the group of patients treated without stabilisation -21.3%. For surgical procedures, the failure rate was up to 3.8%. Statistical analysis showed a significant difference in the number of interrupted observations between the surgical procedures and conservative treatment. Conclusions. The shorter treatment time demonstrated for conservative methods and the associated lower financial expenditure, in the context of treatment of the general public, should be used whenever clinically possible. In more complex cases, it is worth taking into account the advantages of surgical methods.

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Forearm post-traumatic deformities: Classification and treatment

Cited by 6 publications

References 12 publications

Reconstruction using monorail fixator for forearm osteochondroma Masada type I and IIb: A case series

Reconstruction using monorail fixator for forearm osteochondroma Masada type I and IIb: A case series

Multiple Hereditary Exostosis of Distal Ulna with Dislocation of Radial Head: A Case Report

Forearm fractures in children – follow-up study of 137 cases. Comparison and statistical analysis of surgical and conservative treatment

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