Modified gradual ulnar lengthening in treatment of Masada type I forearm deformity caused by hereditary multiple osteochondroma

FAN Jingyi; ZHANG Xuejun; SUN Lin; LI Chengxin; QI Xinyu; SUN Baosheng

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Medical Journal of the Chinese People Armed Police Forces ›› 2023, Vol. 34 ›› Issue (7) : 572-576.

Modified gradual ulnar lengthening in treatment of Masada type I forearm deformity caused by hereditary multiple osteochondroma

FAN Jingyi, ZHANG Xuejun, SUN Lin, LI Chengxin, QI Xinyu, SUN Baosheng

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Abstract

Objective To investigate the clinical effect of modified gradual ulnar lengthening in the treatment of Masada type I forearm deformity caused by hereditary multiple osteochondroma. Methods A total of 10 (11 limbs) patients with Masada type I forearm deformity caused by hereditary multiple osteochondroma were treated at the Department of Orthopedics of Beijing Children's Hospital affiliated to Capital Medical University from June 2014 to October 2020. The patients, 8 males and 2 females, were (10.0±2.8) years old. The clinical and imaging data were retrospectively analyzed, and the radial articular articular angle (RAA), carpal slip (CS), relative ulna shortening (RUS) were compared before and after surgery. The flexion and extension range of wrist, the ulnar deviation and radial deviation of wrist, the pronation and supination range of forearm and the flexion and extension range of elbow were evaluated. Results The mean follow-up was (38.2±6.6) months, and the mean length of the ulna was (38.9±6.6) mm. There were no statistically significant differences between preoperative and last follow-up in RAA[(40.1°±14.2°) vs. (39.3°±13.8°)], supination of forearm [(48.2°±7.5°) vs. (53.6°±6.0°)], elbow range of motion [(135.5°±3.5°) vs. (136.8°±3.4°)], (P＞0.05). There were significant differences between post-operative and last follow-up in CS [(65.0%±22.5%) vs. (34.1%±10.4%)], RUS [(11.2±2.2)mm vs. (-3.9±5.3)mm], wrist flexion [(40.0°±7.7°) vs. (54.5°±7.9°)], wrist extension [(45.9°±8.6°) vs. (61.4°±6.4°)], ulnar deviation [(42.7°±7.5°) vs. (30.5°±6.5°)], radial deviation [(17.7°±4.7°) vs. (29.1±4.9°)] and pronation of forearm [(59.1°±5.4°) vs. (65.0°±3.9°)], (P<0.05). Pathological fracture occurred in 1 case during follow-up. Conclusions Modified gradual ulnar lengthening can effectively treat Masada type I forearm deformity caused by hereditary multiple osteochondroma and improve forearm function.

Key words

modified gradual ulnar lengthening / hereditary multiple osteochondroma / forearm deformity / Masada type Ⅰ

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FAN Jingyi, ZHANG Xuejun, SUN Lin, LI Chengxin, QI Xinyu, SUN Baosheng. Modified gradual ulnar lengthening in treatment of Masada type I forearm deformity caused by hereditary multiple osteochondroma[J]. Medical Journal of the Chinese People Armed Police Forces. 2023, 34(7): 572-576

References

[1] Bovée J V. Multiple osteochondromas[J]. Orphanet J Rare Dis, 2008,13(3):3-10.
[2] 孙扬,李远,金韬,等. 前臂良性骨肿瘤215例临床流行病学分析[J]. 中国骨与关节杂志, 2015(9):659-663.
[3] Masada K, Tsuyuguchi Y, Kawai H,et al. Operations for forearm deformity caused by multiple osteochondromas[J]. J Bone Joint Surg Br, 1989,71(1):24-29.
[4] Fogel G R, McElfresh E C, Peterson H A, et al. Management of deformities of the forearm in multiple hereditary osteochondromas[J]. J Bone Joint Surg Am, 1984,66(5):670-680.
[5] 吕秉乐,田亚敏,葛立业,等. 尺骨干骺端续连症不同手术方法的疗效观察[J]. 中国骨伤, 2021, 34(7):636-640.
[6] Zhang R, Wang X, Liu S, et al. Hinge positioning method of Ilizarov apparatus in correcting radial head luxation caused by multiple hereditary exostoses[J]. Jt Dis Relat Surg, 2022, 33(1): 40-50.
[7] Yan G, Nan G. Modified osteotomy for treatment of forearm deformities (Masada IIb) in hereditary multiple osteochondromas: a retrospective review[J]. BMC Musculoskelet Disord, 2021, 22(1):943-953.
[8] Li Y, Wang Z, Chen M, et al. Gradual ulnar lengthening in Masada type I/IIb deformity in patients with hereditary multiple osteochondromas: a retrospective study with a mean follow-up of 4.2 years[J]. J Orthop Surg Res, 2020, 15(1):594-602.
[9] 刘秋亮,王鹏亮,史龙彦,等. Ilizarov环形外固定架骨延长技术治疗儿童尺骨骨干续连症[J]. 郑州大学学报(医学版), 2020, 55(6):870-873.
[10] 范竟一,张学军,李承鑫,等. Ilizarov外固定架分步延长法治疗儿童尺骨骨干续连症的疗效[J]. 武警医学, 2017, 28(12):1209-1212.
[11] 陈嘉辉,孙春汉,夏贤生,等. 单臂外固定架尺骨延长治疗儿童骨干续连症9例报告[J]. 实用骨科杂志, 2019 ,25(4):360-362.
[12] 曹舒,方科,肖晟,等. Ilizarov外固定架治疗尺骨骨干续连症的早期疗效分析[J]. 临床小儿外科杂志, 2021, 20(11):1059-1063.
[13] Hamdi N, Mortada H, Al Eid Z, et al. Forearm hereditary multiple exostosis: a retrospective case series study[J]. Cureus, 2022, 14(6):e26039.
[14] Huang P, Zhu L, Ning B. Forearm deformity and radial head dislocation in pediatric patients with hereditary multiple exostoses: a prospective study using proportional ulnar length as a scale to lengthen the shortened ulna[J]. J Bone Joint Surg Am, 2020, 102(12):1066-1074.
[15] Benameur H, Bensaleh S, Alidrissi N, et al. Modified technique of single-bone forearm in the treatment of deformities[J]. Cureus, 2022, 14(6):e26361.
[16] Beutel B G, Klifto C S, Chu A. Timing of forearm deformity correction in a child with multiple hereditary exostosis[J]. Am J Orthop (Belle Mead NJ),2014, 43(9):422-425
[17] 熊家伟,陈剑锋,梁杰,等. 骨痂延长术治疗尺骨远端遗传性多发性骨软骨瘤致前臂畸形的疗效分析[J]. 中国医药导报, 2015, 12(36):78-80,104.
[18] Lu Y, Canavese F, Lin R, et al. Distraction osteogenesis at the proximal third of the ulna for the treatment of Masada type Ⅰ/Ⅱb deformities in children with hereditary multiple exostoses: a retrospective review of twenty cases[J]. Int Orthop, 2022, 46(12):2877-2885.
[19] Baghdadi S, Arabi H, Farhoud A, et al. Clinical and functional outcomes of ulnar lengthening in the treatment of Masada type i forearm deformities in hereditary multiple osteochondromas[J]. J Hand Surg Am, 2020, 45(9):876.e1-876.e7.
[20] 张力,秦泗河,石磊,等. Ilizarov外固定技术治疗多发性骨软骨瘤致前臂畸形[J]. 中国矫形外科杂志, 2019, 27(13):1217-1220.
[21] 张磊,赵斌,秦泗河,等. Ilizarov技术治疗儿童尺骨骨干续连症[J]. 中华骨与关节外科杂志, 2021, 14(6):538-542.
[22] 杨胜松,黄雷, 滕星,等. 外固定架尺骨延长治疗遗传性多发性骨软骨瘤所致前臂畸形[J]. 骨科临床与研究杂志, 2020, 5(1):14-20.
[23] 吕秉乐,李东升,田亚敏,等. Ilizarov技术治疗骨软骨瘤继发前臂畸形患者的效果[J]. 贵州医科大学学报, 2020, 45(10):1236-1240.
[24] Waters P M, Van Heest A E, Ernans J. Acute forearm lengthenings[J].J PediatrOrthop, 1997, 17: 444-449.
[25] 刘振江,张立军,马瑞雪,等.髂骨植骨尺骨延长治疗多发性骨软骨瘤前臂畸形的疗效评价[J].中国矫形外科杂志, 2005, 13, 990- 992.