Document Detail


Forearm deformity in patients with hereditary multiple exostoses: factors associated with range of motion and radial head dislocation.
MedLine Citation:
PMID:  24005199     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
BACKGROUND: There is a high rate of forearm deformity in patients with hereditary multiple exostoses, with many patients developing radial head dislocation associated with ulnar shortening.
METHODS: One hundred and six patients with hereditary multiple exostoses who were fifteen years of age or older were identified with use of a previously compiled database. An independent observer measured flexion and extension of the elbow and wrist as well as supination and pronation of the forearm and recorded the number of exostoses affecting the forearm. Proportional ulnar length was calculated as a percentage of the measured height of the patient ([ulnar length/height] ×100).
RESULTS: Exostoses were identified in 183 (86%) of the 212 forearms that were examined. The distal part of the radius was the most common site and was affected in 73% of the patients. One in seven patients had a dislocated radial head, which was associated with reduced proportional ulnar length (p < 0.001). Both radial head dislocation (p < 0.001) and proportional ulnar length (p < 0.001) were confirmed to be independent risk factors associated with forearm rotation on multivariate regression analysis. In conjunction with other risk factors, both of these factors could be used to predict forearm motion. In addition, a reduced proportional ulnar length was also an independent risk factor for radial head dislocation (p < 0.001).
CONCLUSIONS: Proportional ulnar length could be used as a tool to identify patients who are at risk for diminished forearm motion and radial head dislocation during childhood. Surgical intervention could potentially be offered before deterioration in function and dislocation of the radial head occurs.
LEVEL OF EVIDENCE: Diagnostic Level III. See Instructions for Authors for a complete description of levels of evidence.
Authors:
N D Clement; D E Porter
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of bone and joint surgery. American volume     Volume:  95     ISSN:  1535-1386     ISO Abbreviation:  J Bone Joint Surg Am     Publication Date:  2013 Sep 
Date Detail:
Created Date:  2013-09-05     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0014030     Medline TA:  J Bone Joint Surg Am     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1586-92     Citation Subset:  AIM; IM    
Affiliation:
Department of Orthopaedics and Trauma, The Royal Infirmary of Edinburgh, Little France, Edinburgh EH16 4SA, Scotland, United Kingdom. E-mail address for N.D. Clement: nickclement@doctors.org.uk. E-mail address for D.E. Porter: Daniel.Porter@ed.ac.uk.
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