Ilizarov reconstruction on forearm deformity due to multiple hereditary exostoses

Published by Admin Journal on

Issue
Apr
Year
Volume
1
No. 1

Abstract

Introduction

Multiple hereditary exostoses (MHE) is a rare
medical condition that usually located at the most rapidly
growing ends of long bones and manifested by multiple
lesions and frequently associated with characteristic skeletal
deformities. Management of this disease has many problems.
Therefore, it is a challenge for orthopaedic surgeons for such
cases are rarely found and the complexity they may have. We
did an Ilizarov reconstruction for deformity correction while
maintaining the length of the forearm with good outcome and
no complications.

Materials and methods

We present a series of 3 patients with forearm
deformiy due to MHE. They were between 5-17 years old.
All of them showed a marked ulnar shortening, radial bowing,
and radial head dislocation or subluxation. We performed
corrections using Ilizarov frame to gradually lengthen the ulna
until the most distal part achieved a range of -2 mm from radial
styloid for normal ulnar variance. Subsequently, the distal
radius ulna was temporary transfixed with K wire and the ulnar
lengthening continued along with gradual traction of the radius
until the radial head achieved the level of articulation with the
humoral capitellum. Open reduction was needed, followed
by temporary pin fixation of the radial head to the humoral
capitellum. Osteotomy of the radius was performed in patient
3 (with severe bowing deformity) to straighten the radiu

Results

With Ilizarov method, forearm deformities were
corrected, ulnar deviation was improved, prominence of the
radial head on the lateral elbow was diminished, and gradual
reduction of the radial head on humeral capitellum was safely
completed, therefore, this method optimally maintained the
length of the forearm. All three patients had no complications,
especially no radial nerve injury, and no significant pin track
infection. During the rehabilitation program, there were no
joint stiffness and the elbow and wrist ROMs were improved.

Conclusion

Ilizarov reconstruction is a good choice to treat forearm deformity due to multiple heredity exostoses. It has less complications, good outcome, maintain the length of the forearm, good ROM, and good radiographic parameters followed before and after the operation.

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