Strategies in Trauma and Limb Reconstruction

Register      Login

VOLUME 11 , ISSUE 3 ( November, 2016 ) > List of Articles

Original Article

Multiple osteochondromas (MO) in the forearm: a 12-year single-centre experience

John Ham, Mark Flipsen, Marianne Koolen, Arnard van der Zwan, Konrad Mader

Keywords : Multiple hereditary exostoses (MHE), Multiple osteochondromas (MO), Masada classification, Forearm reconstruction, Corrective osteotomy, External fixation, Review

Citation Information : Ham J, Flipsen M, Koolen M, van der Zwan A, Mader K. Multiple osteochondromas (MO) in the forearm: a 12-year single-centre experience. 2016; 11 (3):169-175.

DOI: 10.1007/s11751-016-0267-1

License: CC BY-NC-SA 4.0

Published Online: 01-12-2014

Copyright Statement:  Copyright © 2016; The Author(s).


Multiple osteochondromas (MO) are a rare autosomal dominant disorder characterized by the presence of osteochondromas located on the long bones and axial skeleton. Patients present with growth disturbances and angular deformities of the long bones as well as limited motion of affected joints. Forearm involvement is found in a considerable number of patients and may vary from the presence of a simple osteochondroma to severe forearm deformities and radial head dislocation. Patients encounter a variety of problems and symptoms e.g., pain, functional impairment, loss of strength and cosmetic concerns. Several surgical procedures are offered from excision of symptomatic osteochondromas to challenging reconstructions of forearm deformities. We describe visualizing, planning and treating these forearm deformities in MO and, in particular, a detailed account of the surgical correction of Masada type I and Masada type II MO forearm deformities.

PDF Share
  1. Akita S, Murase T, Yonenobu K, Shimada K, Masada K, Yoshikawa H (2007) Long-term results of surgery for forearm deformities in patients with multiple cartilagenous exostoses. JBJS AM 89:1993-1999
  2. Schmale GA, Conrad EU III, Raskind WH (1994) The natural history of hereditary multiple exostoses. J Bone Joint Surg 76A:986-992
  3. Goud AL, de Lange J, Scholtes VAB, Bulstra SW, Ham SJ (2012) Pain, physical and social functioning and quality of life in individuals with hereditary multiple exostoses in the Netherlands. A national cohort study. J Bone Joint Surg 94A:1013-1020
  4. Wuyts W, van Hul W, Wauters J et al (1996) Positional cloning of a gene involved in hereditary multiple exostoses. Hum Mol Genet 5:1547-1557
  5. Jennes I, Pedrini E, Zuntini M et al (2009) Multiple osteochondromas: mutation update and description of the multiple osteochondromas mutation database (MOdb). Hum Mutat 30:1620-1627
  6. Westhoff B, Stefanovska K, Kraupse R (2014) Multiple kartilaginäre Exostosenkrankheit. Orthopäde 43:725-732
  7. Shapiro F, Simon S, Glimcher MJ (1979) Hereditary multiple exostoses. Anthropometric, roentgenographic, and clinical aspects. J Bone Joint Surg Am 61(6A):815-824
  8. Taniguchi K (1995) A practical classification system for multiple cartilaginous exostosis in children. J Pediatr Orthop 15(5):585-591
  9. Ham SJ (2013) Multiple hereditary exostoses. Clinical problems and therapeutic solutions. Orthop Trauma 27:118-125
  10. Litzelmann E, Mazda K, Jehanna P, Brasher C, Pennecot G-F, Ilarreborde B (2012) Forearm deformities in hereditary multiple exostosis: clinical and functional results at maturity. J Pediatr Orthop 32:1835-1841
  11. Masada K, Tsuyuguchi Y, Kawai H, Kawabata H, Noguchi K, Ono K (1989) Operations for forearm caused by multiple osteochondromas. J Bone Joint Surg Br 71B:24-29
  12. Shin EK, Jones NF, Lawrence JF (2006) Treatment of multiple hereditary osteochondromas of the forearm in children. J Bone Joint Br 88:255-260
  13. Hill RA, Ibrahim T, Mann HA, Siapkara A (2011) Forearm lengthening by distraction osteogenesis in children: a report of 22 cases. J Bone Joint Surg Br 93:1550-1555
  14. Fogel GR, McElfresh EC, Peterson HA, Wicklund PT (1984) Management of deformities of the forearm in multiple hereditary osteochondromas. J Bone Joint Surg Am 66-A:670-680
  15. Burgess RC, Cates H (1993) Deformities of the forearm in patients who have multiple cartilaginous exostosis. J Bone Joint Surg Am 75-A:13-18
  16. Mader K, Gausepohl T, Pennig D (2003) Shortening and deformity of radius and ulna in Children: correction of axis and length by callus distraction. J Pediatr Surg B 12:183-191
  17. Koolen M, Flipsen M, Mader K, Ham J (2016) Evaluation of the surgical management of patients with multiple hereditary osteochondromata of the forearm: a systematic review. Bone Joint J
  18. Noonan KJ, Levenda A, Snead J, Feinberg JR, Mih A (2002) Evaluation of the forearm in untreated adult subjects with multiple hereditary osteochondromatosis. J Bone Joint Surg Am 84-A(3):397-403
  19. Beutel BG, Klifto CS, Chu A (2014) Timing of forearm deformity correction in a child with multiple hereditary exostosis. Am J Orthop 43:422-425
  20. Song SH, Lee H, Youssef H, Oh SM, Park JH, Song HR (2013) Modified Ilizarov technique for the treatment of forearm deformities in multiple cartilaginous exostoses: case series and literature review. J Hand Surg Eur 38:288-296
  21. Villa A, Paley D, Catagni MA, Cattaneo R (1990) Lengthening of the forearm by the Ilizarov technique. Clin Orthop Rel Res 250:125-137
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.