Department of Orthopedics, Hunan Provincial People's Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha, People's Republic of China.
Department of Orthopedics, The Second Xiangya Hospital, Central South University, No. 139 Renmin Road, Changsha, 410011, Hunan, People's Republic of China.
Sci Rep. 2023 Jun 29;13(1):10554. doi: 10.1038/s41598-023-37532-z.
Few articles have reported on the treatment of Masada type 2 forearm deformities in hereditary multiple exostosis, possibly because of the high redislocation rate and other complications. This study precisely declares the use of modified ulnar lengthening by an Ilizarov external fixation with tumour excision for the treatment of Masada type 2 forearm deformities. 20 children with Masada type 2 forearm deformities were admitted for surgical treatment at our hospital from February 2014 to February 2021. There were 13 girls and 7 boys, ranging in age from 3.5 to 15 years (mean: 9 years) at the time of operation. We removed the prominent osteochondromas of the distal ulna and the proximal radius, positioned a classic Ilizarov external fixator on the forearm and then performed ulnar transverse one-third proximal diaphyseal subperiosteal osteotomy. We adopted modified ulnar lengthening postoperatively. The effects of surgical correction of deformity and functional improvement of the limb were assessed via regular follow-up and X-ray. The patients were followed up for 36 months, and the ulna was lengthened 26.99 mm on average; all radial heads remained relocated. The radiographic evaluations, including relative ulnar shortening, radial articular angle, and carpal slip, were improved. The functions of the elbow and forearm were all improved after surgery. Modified ulnar lengthening by an Ilizarov external fixation with tumour excision for the treatment of Masada type 2 forearm deformities in hereditary multiple exostoses has been proven to be an effective and reliable technique in the early stage.
鲜有文献报道遗传性多发性外生骨疣的马萨达 2 型前臂畸形的治疗方法，这可能是因为其存在较高的再脱位率和其他并发症。本研究明确提出采用改良尺骨延长术联合伊里扎洛夫外固定架肿瘤切除治疗马萨达 2 型前臂畸形。2014 年 2 月至 2021 年 2 月，我院收治 20 例马萨达 2 型前臂畸形患儿，均接受手术治疗，其中女 13 例，男 7 例；手术时年龄 3.5~15 岁，平均 9 岁。切除尺骨远端和桡骨近端突出的骨软骨瘤，在前臂放置经典的伊里扎洛夫外固定架，然后行尺骨干横断 1/3 近端骨膜下骨切开术，术后采用改良尺骨延长。通过定期随访和 X 线评估手术矫正畸形和肢体功能改善的效果。患者平均随访 36 个月，尺骨平均延长 26.99mm，所有桡骨头均保持再定位。桡腕关节角、尺桡骨相对缩短和腕骨滑移等影像学评估均得到改善。术后肘关节和前臂功能均得到改善。对于遗传性多发性外生骨疣的马萨达 2 型前臂畸形，采用改良的伊里扎洛夫外固定架肿瘤切除联合尺骨延长术治疗，是一种早期有效、可靠的技术。
