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

Abstract

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.

Experience in Surgical Management of Forearm Deformities in Children With Hereditary Multiple Exostoses

“…Прогрессирование деформации костей предплечья может приводить к нарушению соотношений в области плечелучевого сочленения в виде децентрации, подвывиха или вывиха головки лучевой кости и нестабильности лучезапястного сустава [1,2]. IIА тип: наличие вывиха головки лучевой кости на фоне костно-хрящевого экзостоза проксимального метафиза лучевой кости, укорочение локтевой кости.…”