Forearm post-traumatic deformities: classification and treatment

Reconstruction using monorail fixator for forearm osteochondroma Masada type I and IIb: A case series

INTRODUCTION

Osteochondroma (solitary) and multiple hereditary exostoses (plural) are defined as a cartilage-capped bony projection arising on the external surface of bone containing a marrow cavity that is continuous with that of the underlying bone. These tumors grow slowly and develop to cause symptoms such as limited range of motion, joint pain, lumps, and deformities. The use of ulnar distraction osteogenesis has gained popularity in treating deformity in forearm osteochondroma. Problems that arise including bone angulation and persistent radial head dislocation.

CASE PRESENTATION

We describe eight cases of forearm osteochondroma that came to the Prof. Dr. R. Soeharso Orthopedic Hospital, Surakarta, Indonesia. We found two variations in the classification of Masada in these 8 patients, Masada type I and IIB. The main complaint was a bent arm. We decided to do surgery in the form of tumor resection and reconstruction of the deformity by using ulnar gradual lengthening and osteotomies. The results of the procedure were investigated in this study, using clinical and radiological parameters focusing on medium-term functional and structural outcomes.

DISCUSSION AND CONCLUSION

Eight patients had overall good results, although performed with a different sequence of operating techniques. Ulnar lengthening with a monorail fixator is still the main choice in its implementation. Gradual ulnar lengthening improves not only the deformity but also the functionality of the associated forearm.

Single forearm radius and ulna asymmetric lengthening in multiple cartilaginous exostoses: a case report and a long-term follow-up

We describe one case of forearm deformity in a patient affected by multiple cartilaginous exostoses - also known as the forearm 'candy stick deformity'. Surgical treatment usually focuses on the correction of the wrist deformity without correcting the forearm shortening, the latter not being given the same consideration as lower limb shortening. In the presented case, radius and ulna corticotomies were performed and distal forearm deformity and shortening were corrected by two independent monoaxial external fixators, with full pronosupination. It is our belief that simultaneous treatment of forearm shortening and deformity not only results in an improved clinical and functional result but also provides significant psychological benefit. We recommend a long-term follow-up.