Forearm deformities in children with hereditary multiple exostosis (review of literature)

Introduction Hereditary multiple exostoses, according to different authors, account for 16.0 to 43.0 % of all the cases of tumors, tumor-like and dysplastic diseases of the pediatric skeleton. Deformations of the forearm develop in 30-80 % of patients with multiple exostoses. The purpose of our research was a comprehensive presentation of the deformities of the forearm in children that occur in multiple exostoses, assessment of the efficiency of various surgical treatments. Methods We carried out the analysis of scientific medical articles reflecting the options of surgical treatment of this pathology (PubMed database) published between 1984 and 2018. The retrospective analysis of Russian-speaking and English-speaking sources of literature shows that elimination of forearm deformities in hereditary multiple exostoses is performed only in the surgical way. Results Analysis of results of surgical treatment established that 649 interventions published in literature resulted in 5.5 % of excellent, 33.5 % good; 23 % fair and 38 % poor outcomes. The most perspective and widely applied technique is gradual lengthening of the radius as an independent method of treatment, and in combination with other options of surgical interventions. Discussion Deformity recurrence and exostosis in most cases occur in patients with unfinished bone growth. The authors find optimal perform resection of exostosis in combination with other methods of treatment. At present, the dependence of the choice of surgical option on the severity of anatomical changes has not been established. There are no accurate indications to the choice of a specific technique of surgical intervention based on the deformity revealed. Despite improvement of treatment methods, the rate of poor results remains high and reaches 38 %.