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

Matsubara, Hidenori; Tsuchiya, Hiroyuki; Sakurakichi, Keisuke; Yamashiro, Teruhisa; Watanabe, Koji; Tomita, Katsuro

doi:10.1007/s00776-006-1047-4

Cited by 52 publications

(36 citation statements)

References 19 publications

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“…Matsubara et al (2006) reported that the results of the treatment by excision of osteochondromas, correction of radius, and gradual lengthening of ulna with external fixators was satisfactory, especially for elbow and wrist function.…”

Section: Discussionmentioning

confidence: 99%

Modified Ilizarov technique for the treatment of forearm deformities in multiple cartilaginous exostoses: case series and literature review

Song¹,

Lee²,

Youssef³

et al. 2012

J Hand Surg Eur Vol

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The aim of this study is to evaluate the results of gradual ulnar correction and lengthening using the modified Ilizarov technique for the treatment of forearm deformities in patients with multiple cartilaginous exostoses. We retrospectively reviewed 23 forearms in 16 patients. Three different types of operative procedures were performed: (1) corrective osteotomy and gradual lengthening of the ulna, (2) corrective osteotomy of the radius, and (3) excision of exostoses. We evaluated the radiographs; range of motion of the wrist, forearm, and elbow; and functional status using a questionnaire before and after operation. During the clinical interview, post-operative functional status was significantly improved than pre-operative functional status, 12 patients stated that they had no difficulty in performing daily activities, 11 patients stated that they had no pain, and 11 patients stated that the post-operative appearance of the operated forearm was satisfactory. At time of final follow-up, the mean range of motion of the wrist in ulnar/radial deviation, forearm pronation/supination was significantly improved. Also, the radiographic parameters including radial articular angle, carpal slip, radial bowing, and ulnar variance were significantly improved at time of final follow-up. In conclusion, we achieved successful clinical and radiological outcomes in our patients with forearm deformities after treatment with the modified Ilizarov method. However, there could be a recurrence of ulnar shortening and deformity during growth periods in skeletally immature patients.

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Section: Discussionmentioning

confidence: 99%

Modified Ilizarov technique for the treatment of forearm deformities in multiple cartilaginous exostoses: case series and literature review

Song¹,

Lee²,

Youssef³

et al. 2012

J Hand Surg Eur Vol

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“…Unlike reported previously in the literature, the age that ulna lengthening should be performed is not xed and is dependent on the severity of the deformities in present study. Matsubara et al proposed that the recurrence of ulnar shortening might depend more on the extent of damage to the distal ulnar physis [22]. We recommend an individualized treatment plan for Masada type I deformity.…”

Section: Discussionmentioning

confidence: 84%

“…Thus, unlike one bone lengthening, the ulna cannot be lengthened to the anticipated length at one stage without considering the balance between the radius and ulna. In addition, some authors proposed that ulnar overlengthening could result in ulnocarpal impaction and should be not recommended even in patients with higher risk for recurrence [22,23].. In contrast, Hill et al, who mentioned that overcorrection was partially successful at preventing subluxation or dislocation of the radial head [24].…”

Section: Discussionmentioning

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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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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“…Multiple cartilaginous exostoses (MCE) is a disorder of endochondral bone growth with autosomal-dominant inheritance that is characterized by the development of several abnormal cartilage-covered bone prominences, 1 and often indicates severe deformity of forearm bones indicating loss of forearm rotation, wrist, and elbow malfunction and sometimes pain in juvenile.…”

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confidence: 99%

Ulnar Lengthening/Reconstruction of Interosseous Membrane in Treatment of Osteochondroma

et al. 2017

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

Abstract: Background. Multiple cartilaginous exostoses cause various deformities of the epiphysis. In

Cited by 52 publications

References 19 publications

Modified Ilizarov technique for the treatment of forearm deformities in multiple cartilaginous exostoses: case series and literature review

Modified Ilizarov technique for the treatment of forearm deformities in multiple cartilaginous exostoses: case series and literature review

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

Ulnar Lengthening/Reconstruction of Interosseous Membrane in Treatment of Osteochondroma

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