Gradual ulnar lengthening in children with multiple exostoses and radial head dislocation: Results at skeletal maturity

D’Ambrosi, Riccardo; Barbato, A.; Caldarini, Camilla; Biancardi, Elena; Facchini, R.

doi:10.1007/s11832-016-0718-8

Cited by 39 publications

(38 citation statements)

References 35 publications

(64 reference statements)

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“…[14,15] Surgical treatment of these lesions must be taken into consideration only in case of complications development, such as infection, synovial cysts, vascular, or nervous impairment, but also malignant transformation. [16] Callus distraction of the ulna with angular correction of the radius and ulna is used in patients suffering from multiple hereditary osteochondromas to improve forearm function. [17] Nerve compression, another complication encountered in patients with HME, can lead to nerve damage.…”

Section: Discussionmentioning

confidence: 99%

Daughter and mother diagnosed with hereditary multiple exostoses

2017

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Introduction:Hereditary multiple exostoses (HME) or osteochondromatosis is a rare autosomal dominant disease characterized by multiple osteochondromas and skeletal deformities.Patient Concerns & Diagnoses:We present the case of a 5 years and 9 month-old patient who presented with inferior limb pain for approximately 6 months, associating also deformity of the right index finger for a month. Hand X-ray revealed a radiologic abnormality of the right radius, therefore the child was referred to our clinic for further investigations. The X-rays revealed multiple osteochondromas of the radius, metacarpal bones, hand phalangeal bones, femur, tibia, fibula, metatarsal bones, and foot phalangeal bones. We mention that the same radiological aspect was identified in the case of the patient's mother, undiagnosed until that moment.Outcomes:The particularity of this case consists in identification of a rare genetic pathology, HME in a 5-year-old patient, without any known familial history, after the occurrence of a nontraumatic joint dislocation of the right index finger.Conclusion:HME is a rare genetic condition, without a curative treatment, burdened by multiple complications, and whose diagnosis is usually established during childhood.

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Section: Discussionmentioning

confidence: 99%

Daughter and mother diagnosed with hereditary multiple exostoses

2017

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“…The cause may be congenital deficiencies such as fibular hemimelia (Fig. 3), tibial hemimelia or congenital short femur, old poliomyelitis, bone tumours such as hereditary multiple exostosis [34] or past trauma. Bilateral lengthening may be indicated in cases of dwarfism caused by achondroplasia, especially if it is accompanied by deformities such as genu varum.…”

Section: Indications For Limb Lengtheningmentioning

confidence: 99%

Limb lengthening history, evolution, complications and current concepts

Hosny

2020

J Orthop Traumatol

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Limb lengthening continues to be a real challenge to both the patient and the orthopaedic surgeon. Although it is not a difficult operative problem, there is a long and exhausting postoperative commitment which can jeopardize early good results. I aim to review the history, evolution, biology, complications and current concepts of limb lengthening. Ilizarov's innovative procedure using distraction histeogenesis is the mainstay of all newly developing methods of treatment. The method of fixation is evolving rapidly from unilateral external fixator to ring fixator, computer assisted and finally lengthening intramedullary nails. The newly manufactured nails avoid many of the drawbacks of external fixation but they have their own complications. In general, the indications for limb lengthening are controversial. The indications have been extended from lower limb length inequality to upper extremity lengthening, including humeral, forearm and phalangeal lengthening. A wide range in frequency of complications is recorded in the English literature, which may reach up to 100% of cases treated. With developing experience, cosmetic lengthening has become possible using external or internal lengthening devices with an acceptable rate of problems. Level of evidence: V.

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“…Also, 213 cases of multi-planar deformities of long bones (of which only 7 cases were patients with a diagnosis of "Multiple hereditary exostoses") were described [22]. Deformity severity at the preoperative stage was assessed using the reference lines and angles.…”

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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Gradual ulnar lengthening in children with multiple exostoses and radial head dislocation: Results at skeletal maturity

Cited by 39 publications

References 35 publications

Daughter and mother diagnosed with hereditary multiple exostoses

Daughter and mother diagnosed with hereditary multiple exostoses

Limb lengthening history, evolution, complications and current concepts

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

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