The Analysis Of Outcome Of Gradual Ulnar Lengthening For The Treatment Forearm Shortening Deformity In Children With Hereditary Multiple Exostose

Objective:To analyze the outcomes and complications of gradual ulnar lengthening to treat forearm shortening deformity by monolateral external fixator in children with hereditary multiple exostoses.Methods:A retrospectively reviewed was performed on twenty patients(twenty-one forearms)who underwent gradual ulnar lengthening to correct forearm shortening deformity because of hereditary multiple exostoses by monolateral external fixator in the First Affiliated Hospital of Guangxi Medical University from June 2012 to December 2018.There were 10 males and 10 females,with an average age of 8.7 years at the time of surgery.All children were treated by gradual ulnar lengthening with exostoses removal.The radiologic evaluation and functional evaluation were compared between the preoperative and the final follow-up.Radiologic evaluation included the relative ulnar shortening(US),radial articular angle(RAA),and carpal slip(CS).Function evaluation included flexion and extension of wrist,radial-deviation and ulnar-deviation of wrist,rotation of forearm,flexion and extension of elbow and Mayo elbow performance score.Results:Twenty patients(twenty-one forearms)were followed up for an average of 14.3 months(range from 3 to 52 months).At the final follow-up,the US,RAA and CS were-3.9±6.4mm?27.8±3.7°?51±2.7% respecityly.It obtained obviously improvement,and the differences were statistically significant(p<0.05).The flexion and extension of wrist,radial-deviation and ulnar-deviation of wrist,pronation of forearm,flexion and extension of elbow and Mayo elbow performance score improved significantly after operation,and the differences were statistically significant(p<0.05).Conclusions:Gradual ulnar lengthening to treat forearm shortening deformity in children with hereditary multiple exostoses by monolateral external fixator is not only can correct raletive ulnar shortening,ulnar deviation of the wrist,radial head dislocation,cubitus varus/valgus deformity,but also can improve forearm,wrist and elbow function remarkably.The short-term outcome is effective.