Reconstruction of Forearm Deformity by Distraction Osteogenesis in Children With Relative Shortening of the Ulna Due to Multiple Cartilaginous Exostosis

Vogt, B; Tretow, Henning; Daniilidis, Kiriakos; Wacker, S.; Buller, Tim C.; Henrichs, Marcel-Philipp; Roedl, Robert; Schiedel, F.

doi:10.1097/bpo.0b013e31821a5e27

Cited by 43 publications

(35 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…2 Anatomic reduction and stable fixation of ulnar fractures, especially in Monteggia variants, are essential to ensure an accurate reduction of the radial head. [4][5][6][7] The findings in this study suggest that the AP ulnar proximal angle in skeletally immature children is smaller than in adults and is located relatively more distal. Therefore, knowing the parameters that define the normal ulna may help the treating surgeon in managing these pathologies.…”

Section: Discussionmentioning

confidence: 58%

“…Monteggia fracture-dislocation of the proximal ulna and radius is rare (2% to 5% of elbow injuries) and extremely difficult to treat because only an anatomic reduction can restore joint congruence, fracture stabilization, and subsequent functional rehabilitation. [5][6][7] The adult ulna has been previously described in the literature in cadaveric studies with general consensus on the mean varus angulation of the proximal ulna (17.5, 17.7 degrees) and the mean distance from the triceps insertion to the ulnar proximal angulation point (8.54, 7.32, 7.6 cm). Similar upper limb deformities are also common in patients with osteogenesis imperfecta.…”

mentioning

confidence: 99%

See 1 more Smart Citation

A Radiographic Study of Pediatric Ulnar Anatomy

Cravino

Oni

Sala

et al. 2014

Journal of Pediatric Orthopaedics

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 58%

mentioning

confidence: 99%

A Radiographic Study of Pediatric Ulnar Anatomy

Cravino

Oni

Sala

et al. 2014

Journal of Pediatric Orthopaedics

View full text Add to dashboard Cite

show abstract

“…Akita 10 reported similar phenomena in corrective surgery that initial improvement was lost after 13 years of follow-up. Analysis of the raw data in Vogt et al 12 and Tang et al 14 series showed that the final improvement in UV fell short of the initial ulnar lengthening in 71% of cases (Table 3). This rebound phenomenon is poorly understood.…”

Section: Discussionmentioning

confidence: 97%

Excision of Distal Ulnar Exostosis: A Case Series and Literature Review

Yip

Choi

Tak

et al. 2018

Journal of Orthopaedics, Trauma and Rehabilitation

View full text Add to dashboard Cite

Background: Multiple Hereditary Exostoses with distal ulnar exostosis often results in forearm deformity and functional restrictions. Literature reported variable outcomes and frequent complications with an aggressive approach of ulna lengthening. The role of distal ulnar exostosis excision remained uncertain with contradictory effect in restoring growth. Our study aimed to report our outcome of simple excision and compare with the reported results in literature. Method: Retrospective review was carried out in patients with distal ulnar exostoses excision who were operated from 2003 to 2011. Patients with less than 3 years of follow-up, radial head dislocation or subluxation, or within 3 years of skeletal maturity were excluded. Clinical outcome including range of forearm rotation was documented. Radiological outcomes including radial articular angle, carpal slip, ulnar variance and radial bowing were measured. The results were analysed statistically and compared with literature. Results: Five cases were included in our study. All had excision of exostosis, and one case had additional ulnar lengthening. Mean age of operation was 10.4 years. Mean follow-up time was 72 months. Improvement was shown in the range of pronation, radial articular angle, carpal slip and ulnar variance, in the cases with simple excision alone. Improvements were mostly achieved at the first postoperative year. However, for the case with concomitant lengthening, ulna shortened relatively with growth, and complications were reported. This phenomenon is in keeping with the literature finding. Conclusion: Simple excision of distal ulnar exostosis improves forearm rotation and provides some restoration of growth in skeletally immature patients with Masada type I deformity.

show abstract

“…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

View full text Add to dashboard Cite

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.

show abstract

Reconstruction of Forearm Deformity by Distraction Osteogenesis in Children With Relative Shortening of the Ulna Due to Multiple Cartilaginous Exostosis

Cited by 43 publications

References 0 publications

A Radiographic Study of Pediatric Ulnar Anatomy

A Radiographic Study of Pediatric Ulnar Anatomy

Excision of Distal Ulnar Exostosis: A Case Series and Literature Review

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

Contact Info

Product

Resources

About