The treatment of hereditary multiple exostosis of the upper extremity

Secondary chondrosarcoma in osteochondromas Medullary extension in 15 of 45 cases

“…The same was reported by Evans et al (1977), Garrison et al (1982), and Huvos (1991). The male preponderance might be partially due to the finding of a decreased expression in many involved women with multiple osteochondromas, resulting in fewer clinical manifestations (Wood et al 1985). This is in accordance with our series, where the difference in sex distribution is especially due to a large group of men with multiple osteochondromas.…”

Tumor Location Affects the Results of Simple Excision for Multiple Osteochondromas in the Forearm

“…Such deformity is caused by a combination of shortening of the ulna, bowing of the radius, and ulnar deviation of the wrist, and, occasionally, radial head dislocation 1 . Radial articular deformity in association with multiple osteochondromas (an increasing radial articular angle) may be induced by tethering of the shortened distal aspect of the ulna, as first proposed by Solomon in 1961 2 , and subsequently supported by several other studies [3][4][5] . Solomon also theorized that relative ulnar shortening was accommodated by either bowing of the radius or dislocation of the radial head proximally.…”

“…Tumor excision is the most common surgical treatment, and this procedure can be combined with other surgical methods, including ulnar lengthening, radial osteotomy, and hemiepiphysiodesis, depending on the severity and pattern of the deformity [3][4][5][8][9][10][11][12][13] . However, the variety of combinations of surgical procedures has made it difficult to assess the effectiveness of each procedure for the correction of the deformity, leading to a long-standing controversy regarding the overall effectiveness of the excision of osteochondromas in controlling the progression of a deformity.…”

Correction and lengthening for deformities of the forearm in multiple cartilaginous exostoses

“…10 Prichett reported that lengthening of the ulna and correction of the radius, particularly with the use of an external fixator, has given predictable results and is a useful method of treating forearm deformity in patients with hereditary multiple exostoses. 1 It appears that we reached the consensus of a need for lengthening and normalization of the relationship of the radius and ulna, but controversy in the literature now exists regarding whether forearm lengthening is best achieved immediately or gradually.…”