| Objective To explore the curative effect of gradual lengthening ofthe ulna for forearm deformities caused by hereditary multipleosteochondroma and significance of intraoperative excision ofosteochondroma.Methods A retrospective analysis of16patients(16arms) withforearm deformities caused by HME adopted ulnar lengthening during June2010and June2013. Keep a record of preoperative radiographs andforearm range of motion. Group A(seven cases) received simple gradualulnar lengthening.Group B(9cases) received intraoperative excision ofosteochondroma. Gradual ulnar lengthen after operation with1mm/d to thescheduled length and followed up for7to31months. Compare the X-rayindexes and functional changes pre-operation and at latest follow up. Andanalyze the correlation between radial head dislocation, forearm rotationand other factors in this study.Results16cases were satisfactorily followed up for7months to31months, with an average of16months. In both groups, RUS, CS,UB are significantly reduced and ROM of wrist, elbow and forearm rotation aresignificantly improved compared with preoperative(P <0.05), but nosignificant difference between the two. Preoperatively9cases arecomplicated with radial head dislocation preoperative, with satisfyingreduction in6cases(3in Group A,3in Group B), partial reduction in3(Group A).Epiphyseal plate of distal ulna is clear seen in4cases in GroupB with0in Group A. Moreover, radial head is consider to be associatedwith RUS(P=0.042) and CS(P=0.007). Forearm rotation is consider to beassociated with radial head dislocation(P=0.031), RUS(P=0.045) and ageof operation(P <0.01).Conclusion Gradual ulnar lengthening can correct shortening,bending of ulna, radial head dislocation and carpal shift and slowly recoverthe radial inclination and partially recover the function of forearm, elbow,wrist joint. Parallel osteochondroma resection is in favor of regain of distalulna epiphyseal plate, delaying recurrence of deformities. |
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