Management of forearm deformity in multiple hereditary osteochondromatosis

The records of 97 patients with multiple hereditary osteochondromatosis were retrospectively reviewed. Seventy-eight patients had one or more osteochondroma(s) of one or both forearm(s). Fifty-three operations were performed, of which 41 were excisions of symptomatic osteochondromas or dislocated radial heads. All forearm, wrist, and elbow radiographs were reviewed. Four common radiographic parameters were measured: radial articular angle, carpal slip, relative ulnar shortening, and forearm-third metacarpal angle. Thirty-seven of these 78 patients were contacted by telephone questionnaire. The results indicated that skeletally mature patients do well on a functional basis and are comfortable with their appearance, despite deformity. Surgery can improve aesthetic appearance and provide pain relief when done before or after skeletal maturity. Because of these results, we are less aggressive in the early treatment of forearm deformities.