Single-stage treatment of complete dislocation of radial head and forearm deformity using distraction osteogenesis in paediatric patients having multiple cartilaginous exostosis.

Abstract

BACKGROUND:

We are reporting the results of single-stage treatment for patients with forearm deformity and radial head luxation due to hereditary multiple exostosis using distraction osteogenesis.

METHOD:

Six patients with a mean age of 12 years were treated. Morphological evaluation was made according to Masada (3 of the cases were 2a and 3; 2b). Angular deformities of forearm and wrist were evaluated as described by Fogel (distal radial joint angle was 27°, ulnar variance was 12.8 mm and carpal slip was 71.3%). Mean forearm pronation was 48.4° whilst mean supination was 19.2°. Mean elbow range of motion was 26.6°-103.4° and the mean DASH score was 75. Common surgical procedures were deformity correction, ulnar lengthening and gradual radial head reduction using external fixators.

RESULTS:

Mean follow-up period was 4.2 years and mean external fixation time was 6 months. Mean amount of ulnar lengthening was 2.9 cm and the distraction index was 14.9 cm/day. Mean radial articular angle was 14.3°, ulnar variance 2.3 mm, carpal slip 55%, forearm pronation 65.9° and supination was 55°. Mean elbow range of motion was 15.8°-119.2°. In the last follow-up, the mean value of DASH score was 8.1. Major and minor complications were seen during the follow ups.

CONCLUSIONS:

Single-stage deformity correction, ulnar lengthening and radial head reduction technique that we have used provide satisfactory functional and cosmetic results. Early surgical correction may lead to even better results.

• Authors: Bilal Demir, Sarper Gursu, Kahraman Ozturk, Timur Yildirim, Mehmet Nuri Konya, Turgay Er
• Journal: Archives of orthopaedic and trauma surgery (Arch Orthop Trauma Surg) Vol. 131 Issue 9 Pg. 1195-201 (Sep 2011) ISSN: 1434-3916 [Electronic] Germany
• PMID: 21298437 (Publication Type: Journal Article)

Topics

• Adolescent
• Child
• Elbow Joint (pathology, physiopathology, surgery)
• Exostoses, Multiple Hereditary (complications, pathology, surgery)
• Female
• Follow-Up Studies
• Forearm (pathology, surgery)
• Humans
• Joint Dislocations (etiology, surgery)
• Male
• Osteogenesis, Distraction (methods)
• Radius (pathology, surgery)
• Range of Motion, Articular
• Treatment Outcome
• Ulna (pathology, surgery)