Rp. Stanton et Mo. Hansen, FUNCTION OF THE UPPER EXTREMITIES IN HEREDITARY MULTIPLE EXOSTOSES, Journal of bone and joint surgery. American volume, 78A(4), 1996, pp. 568-573
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.