Surgical treatment of wrist deformity in hereditary multiple exostosis.


Published online: Dec 27 1997

T U Jiya, J E Pruijs, and J W van der Eijken.

Department of Paediatric Orthopaedics, University Hospital for Children and Youth, Utrecht, The Netherlands.

Abstract

Wrist deformity represents a unique problematic entity in patients with Hereditary Multiple Exostosis (HME). We report our experience in the treatment of wrist deformities due to HME using three surgical procedures and the outcome of 12 wrist surgical corrections by comparing preoperative, postoperative and last follow-up radiographic values of the carpal slip, radial articular angle and ulnar shortening. Eight out of 12 forearms did show a postoperative improvement of the radiographic parameters, although recurrence of the deformity occurred frequently. Two forearms showed no change in postoperative radiologic parameters. The average age at operation was 13 years, 4 months and the average duration of follow-up was 76.1 months. Prevention and reducing the progression of deformity and functional disability is an important goal in the management of these patients. The type of deformity is the most important factor in deciding the type of surgery to be performed.