Gradual Lengthening of the Ulna in Patients with Multiple Hereditary Exostoses with a Dislocated Radial Head

Cho, Yong Jin; Jung, Sung Taek

doi:10.3349/ymj.2014.55.1.178

Cited by 26 publications

(24 citation statements)

References 18 publications

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“…Ham et al also suggested delaying the lengthening until after the age of 13-15 years [12]. Other studies reported satisfactory results after ulnar lengthening, but the mean follow-up times of their patients were short (< 2.5 years) [3,4] or the age at intervention was older than 10 years [5]. With a mean follow-up time of 4.2 years, the analysis of the radiographic parameters in this study shows initial improvement and then deterioration at last follow-up, however, the ulnar shortening and forearm pronation improved signi cantly by ulnar lengthening, and the cosmetic appearance improved signi cantly with the change of carrying angle (Fig.…”

Section: Discussionmentioning

confidence: 99%

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Management of Masada type I/IIb forearm deformity by gradual ulnar lengthening in patients with hereditary multiple osteochondromas

Li¹,

Wang²,

Mu³

et al. 2020

Preprint

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Background Gradual ulnar lengthening is the most commonly used procedure in treatment of Masada type I/II deformity in patients with hereditary multiple osteochondromas. However, the treatment remains controversial for the recurrence of deformity in growing children and only slightly handicapped of daily life activities in untreated adult patients. The aim of this study was to evaluate mid-term clinical and radiological outcomes of ulnar gradual lengthening in our clinic. Methods We retrospectively reviewed patients who underwent ulnar lengthening by distraction osteogenesis from June 2008 to October 2017. Patients with less than two years of follow-up were excluded. The surgical procedures consisted of ulnar lengthening by external fixator and/or excision of the osteochondroma at the distal ulna. The carrying angle (CA) and range of motion (ROM) of the forearm and elbow were clinically assessed, and the radial articular angle (RAA) and ulnar shortening (US) were radiologically assessed before lengthening, two months after external frame removal, and at the last follow-up. Results The current study included 15 patients (17 forearms) with a mean age of 9.4 ± 2.3 years at index surgery. The mean follow-up period was 4.2 ± 2.4 years. There were 9 patients (10 forearms) with Masada type I deformity and 6 patients (7 forearms) with Masada type IIb deformity. The mean amount of ulnar lengthening was 4.2 ± 1.2 cm. The mean RAA improved from 37.3 ± 7.9° to 29.8 ± 6.5° initially (P = 0.003) and relapsed to 34.4 ± 7.6° at the last follow-up (p = 0.234). There was minimal deterioration of US yet significant improvement at the last follow-up compared to pre-op (p < 0.001). The elbow flexion and forearm pronation were improved significantly at last follow-up (p < 0.001 and p = 0.024, respectively). The mean carrying angle improved significantly from − 6.3 ± 7.4 ° preoperatively to 7.4 ± 11.1° at last follow-up (p < 0.001). Conclusions Gradual ulnar lengthening significantly reduces cosmetic deformity and improves function; it is recommended for patients with Masada type I/IIb deformity. Therefore, we advocated aggressive individual treatment protocol for patients with Masada type I/IIb deformities.

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Section: Discussionmentioning

confidence: 99%

“…[1,2]. Gradual ulnar lengthening has been widely used with successful reported results in managing forearm deformity [3][4][5][6][7]. However, the treatment remains controversial.…”

mentioning

confidence: 99%

Management of Masada type I/IIb forearm deformity by gradual ulnar lengthening in patients with hereditary multiple osteochondromas

Li¹,

Wang²,

Mu³

et al. 2020

Preprint

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“…A few articles deal with forearm deformities, including the deformities of the forearm in this genetic disease of multiple hereditary [23][24][25].…”

Section: Discussionmentioning

confidence: 99%

Clinical and radiological characteristics of forearm deformities in children with multiple hereditary exostoses

Zakharyan¹,

Белоусова²,

Pozdeev³

2019

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Introduction The incidence of forearm deformities in children with multiple hereditary exostoses (MHE) ranges from 30 to 80 %. There are few studies of deformities of the forearm in MHE patients in the literature that describe not only the location of exostoses and position of the head of the radius but also the true variants of forearm deformities. The aim of the study was to investigate forearm bone deformities in patients with multiple hereditary exostoses. Materials and methods Radiographs of the bones of the forearm in 84 patients (151 limbs) diagnosed with multiple hereditary exostoses in the age of four to 17 years who were treated at our institute from 2004 to 2018 were retrospectively analysed. The study involved 47 boys and 37 girls; 67 patients (80 %) had bilateral lesions, and 17 patients (20 %) had lesions of only one upper limb. Patients were divided into four groups depending on the type according to the Jo& Jung's classification. The deformities were evaluated based on radiological methods in accordance with the reference lines and angles for the forearm bones. Results The most common variants of forearm deformities were revealed: varus recurvatum at the border of the upper and middle third of the ulna (55 %), varus recurvatum at the border of the upper and middle third of the ulna associated with varus of the radius in the middle third (15 % of cases); as well as their combinations accompanied by dislocation or subluxation of the radial head (30 %). RAA (radial articular angle) and RB (radial bowing) did not have significant difference in various types of deformities of the forearm according to Jo&Jung's classification. Conclusion The study of the variety of forearm deformities in children due to multiple hereditary exostoses will assist in a differentiated approach to the choice of surgical treatment methods depending on the type of deformity.

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“…In adults with radial longitudinal deficiency, factors such as grip strength, forearm length, and digital motion are more important for the individual's activity than radial angulation at the wrist 54 . In patients with multiple hereditary exostoses and a dislocated radial head, comprehensive treatment including excision of the forearm osteochondromas and gradual lengthening of the ulna improved clinical and radiographic parameters 55 .…”

Section: Pediatric and Adult Reconstructionmentioning

confidence: 99%

What’s New in Limb Lengthening and Deformity Correction

Sabharwal¹,

Green

McCarthy

et al. 2015

The Journal of Bone and Joint Surgery

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Gradual Lengthening of the Ulna in Patients with Multiple Hereditary Exostoses with a Dislocated Radial Head

Cited by 26 publications

References 18 publications

Management of Masada type I/IIb forearm deformity by gradual ulnar lengthening in patients with hereditary multiple osteochondromas

Management of Masada type I/IIb forearm deformity by gradual ulnar lengthening in patients with hereditary multiple osteochondromas

Clinical and radiological characteristics of forearm deformities in children with multiple hereditary exostoses

What’s New in Limb Lengthening and Deformity Correction

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