Service chirurgie orthopédique, Hôpital Necker - Université Paris Cité, 149 Rue de Sèvres, 75015 Paris, France.
Service de santé publique du Pr. Carrat, Hôpital Saint-Antoine, 184 Rue du Faubourg Saint-Antoine, 75012 Paris, France.
Orthop Traumatol Surg Res. 2023 Sep;109(5):103591. doi: 10.1016/j.otsr.2023.103591. Epub 2023 Mar 10.
In patients who have hereditary multiple osteochondroma (HMO), progressive deformity of the forearm skeleton may lead to radial head dislocation. The latter is permanent, painful and causes weakness.
There is a relationship between the amount of ulnar deformity and the presence of radial head dislocation in patients with HMO.
This was a cross-sectional radiographic study comprising an analysis of anterior-posterior (AP) and lateral x-rays of 110 forearms in children having a mean age of 8 years and 4 months who were followed for HMO between 1961 and 2014. Four factors reflecting on the ulnar deformity in the coronal plane were investigated on the AP view and three factors in the sagittal plane were investigated on the lateral view to identify any relationship between ulnar deformity and radial head dislocation. The forearms were separated into two groups: with radial head dislocation (26 cases) and without radial head dislocation (84 cases).
Ulnar bowing, intramedullary angle of ulnar bowing, tangent ulnar angle and overall ulnar angle were significantly higher in the group of children who had a radial head dislocation (0.05 vs 0.03, p<.001; 161 vs 167, p<001; 156 vs 162, p<001; 50 vs 30, p<.001) in univariate and multivariate analyses.
Ulnar deformity, evaluated using the method described here, is more often associated with radial head dislocation than other previously published radiological parameters. This provides new insight on this phenomenon and may help to determine which factors are associated with radial head dislocation and how to prevent it.
Ulnar bowing in the context of HMO, especially when evaluated on AP radiographs, is significantly associated with radial head dislocation.
III; case-control study.
患有遗传性多发性骨软骨瘤（HMO）的患者，前臂骨骼的进行性畸形可能导致桡骨头脱位。后者是永久性的，疼痛且会导致无力。
在 HMO 患者中，尺骨畸形的程度与桡骨头脱位的存在之间存在关系。
这是一项横断面影像学研究，包括对 1961 年至 2014 年间接受 HMO 随访的 110 例儿童的前后位（AP）和侧位 X 射线进行分析。在 AP 视图上研究了反映冠状面尺骨畸形的四个因素，在侧位视图上研究了矢状面的三个因素，以确定尺骨畸形与桡骨头脱位之间的任何关系。将前臂分为两组：桡骨头脱位组（26 例）和无桡骨头脱位组（84 例）。
在桡骨头脱位的儿童组中，尺骨弯曲、尺骨弯曲的髓内角、切线尺骨角和整体尺骨角明显更高（0.05 比 0.03，p<.001；161 比 167，p<001；156 比 162，p<001；50 比 30，p<.001），无论是在单变量还是多变量分析中。
使用此处描述的方法评估的尺骨畸形与桡骨头脱位的关系比其他先前发表的影像学参数更密切。这为这种现象提供了新的认识，并可能有助于确定哪些因素与桡骨头脱位相关，以及如何预防它。
在 HMO 的背景下，特别是在 AP 射线照片上评估时，尺骨弯曲与桡骨头脱位显著相关。
III；病例对照研究。
