DEFORMITIES AND PROBLEMS OF THE FOREARM IN CHILDREN WITH MULTIPLE HEREDITARY OSTEOCHONDROMATA

Multiple hereditary osteochondromata is the most common benign bone tu mor. Deformities of the forearm are the most frequent cause of functio nal impairment in these patients. The most common deformity is a combi nation of relative shortening of the ulna, bowing of the radius and/or ulna, increased ulnar tilt of the distal radial epiphysis, ulnar devi ation of the hand, progressive ulnarward translocation of the carpus, and subluxation/dislocation of the proximal radial head. In addition t o relative shortening and cosmetic displeasure, these deformities comm only produce limited forearm rotation, limited wrist motion, and, when the radial head dislocates, both elbow pain and loss of motion. This article reviews all surgical procedures currently in use, and attempts to synopsize the current thinking about how best to treat these defor mities. Preventing and reducing progression of deformity and functiona l impairment, particularly radial head dislocation, remain paramount g oals, and aggressive management is advocated.