FUNCTION OF THE UPPER EXTREMITIES IN HEREDITARY MULTIPLE EXOSTOSES

The radiographic anatomy, functional status, and impairment ratings of twenty-eight patients (fifty-six extremities) who had hereditary mult iple exostoses were evaluated. The patient (or the parent) also subjec tively graded the function of each extremity with use of a standard ra ting-assessment tool. Degenerative joint disease was evident in three (5 per cent) of the fifty-six extremities at the time of follow-up, wh en the patients were an average of twenty-one years old, With use of t he hand test of Jebsen ct al., the average score was in the forty-seve nth percentile for the dominant extremity and in the twenty-eighth per centile for the non-dominant extremity. Loss of pronation and supinati on increased with increasing age. Dislocation of the radial head was s ignificantly associated with negative ulnar variance (p = 0.008) and w ith the impairment rating (p = 0.001), but not with the subjective sco re or with the performance on the hand test of Jebsen et al, So-called whole-person impairment ratings ranged from 0 to 17 per cent (average , 5 per cent). It has been our experience that deformities of the uppe r extremity in patients who have hereditary multiple exostoses are wel l tolerated and lead to little loss of function as measured both subje ctively and objectively.