Abstract
Deformity of the lower extremities in 26 patients with multiple cartilaginous exostosis was examined radiologically. Follow-up periods ranged between 3 and 33 years (mean 10.3 years). Twenty-four patients had deformity of the joints. A femoral neck-shaft angle (FNA) of more than 150° was noted in 14 patients (26 of 51 hip joints) at diagnosis. After approximately 10 years of age, the FNA tended to decrease. Eleven patients (22 of 52 knee joints) had genu valgum (the femorotibial angle < mean −2 SD of normal control) which was caused by valgus deformity of the distal femur in one-third of the patients and that of the proximal tibia in two-thirds. Fifteen of 21 patients (29 of 42 joints) had valgus deformity of the ankle (antero-posterior mortise angle of the ankle > 94c), and in half of them, the valgus deformity progressed with growth. Two patients (aged 10 and 11 years) underwent varus osteotomy of the tibia with partial excision of the fibula. However, their deformity relapsed. Surgical treatment for hip deformity is unnecessary during the growth stage. Progressive deformity of the knee and ankle should be detected in an early stage, and the surgical indication has to be examined.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Beals RK (1991) The treatment of ankle valgus by surface epiphysiodesis. Clin Orthop 266:162–169
Boyer A (1814) Traité des maladies chirurgicales. Vol 3. Ve Migneret, Paris
Coley BL (1960) Neoplasms of bone and related conditions, 2nd edn. Paul B Hoeber, New York
Dahlin DC, Unni KK (1986) Osteochondroma. In. Dahlin DC, Unni KK (eds) Bone tumors, 4th edn. Charles C Thomas, Springfield, pp 18–32
Dennis SW, Walter AH Jr (1978) The development of the upper end of the femur in multiple hereditary exostosis. Clin Orthop 137:187–190
Dietz FR, Merchant TC (1990) Indications for osteotomy of the tibia in children. J Pediatr Orthop 10:486–490
Enneking WF (1990) Benign skeletal lesions. In: Enneking WF (ed) Clinical pathology, 3rd revised edn. University Florida Press, Gainesville, pp 318–324
Fogel GR, McElfresh EC, Peterson HA, Wicklund PT (1984) Management of deformities of the forearm in multiple hereditary osteochondromas. J Bone Joint Surg [Am] 66:670–680
Hachiya M, Yamada K, Takao Y (1986) Bow legs and knock knees in children with special reference to chronological changes of femorotibial angle. J Jpn Orthop Assoc 60:S114
Huvos AG (1991) Multiple osteocartilaginous exostosis (hereditary multiple exostosis, diaphyseal aclasis). In: 1991 (ed) Bone tumors, 2nd edn. Saunders, Philadelphia, pp 264–268
Jaffe HL (1958) Tumors and tumorous conditions of the bone and joints. Lea & Febiger, Philadelphia
Kai M (1937) A radiological measurement of proximal femur. Jap J Orthop Assoc 12:389
Kieth A (1919–1920) Studies on the anatomical changes which accompany certain growth disorders of the human body. I. The nature of the structural alterations in the disorder known as multiple exostoses. J Anat 54:101–115, 1919–1920
Masada K, Tsuyuguchi Y, Kawai H, Kawabata H, Noguchi K, Ono K (1989) Operations for forearm deformity caused by multiple osteochondromas. J Bone Joint Surg [Br] 71:24–29
McComack EB (1981) The surgical management of hereditary multiple exostosis. Orthop Rev 10:57
Moji J (1980) Roentgenological measurement of the shape of the osteoarthritic ankle. Jpn J Orthop Assoc 54:791–802
Mueller E (1913–1914) Über hereditary multiple cartilaginäre Exostosen und Ecchondrosen. Beitr Pathol Anat 57:232–281
Ogden JA (1976) Multiple hereditary osteochondromata: report of an early case. Clin Orthop 116:48
Peterson HA (1989) Multiple hereditary osteochondromata. Clin Orthop 239:222–230
Peterson HA (1994) Deformities and problems of the forearm in children with multiple hereditary osteochondromata. J Pediatr Orthop 14:92–100
Rechlinghausen F von (1866) Ein Fall von multiplen Exostosen. Arch Pathol Anat Phys 35:203–207
Shapiro F, Simson S, Glimcher MJ (1979) Hereditary multiple exostoses. J Bone Joint Surg [Am] 61:815–824
Snealy WN, Peterson HA (1989) Management of ankle deformities in multiple hereditary osteochondromata. J Pediatr Orthop 9:427–432
Solomon L (1961) Bone growth in diaphysial aclasis. J Bone Joint Surg [Br] 43:700–716
Solomon L (1963) Hereditary multiple exostosis. J Bone Joint Surg [Br] 45:292–304
Solomon L (1964) Hereditary multiple exostosis. Am J Hum Genet 16:351
Takei Y (1992) Follow-up study of multiple osteocartilaginous exostosis. Cent Jpn Orthop Traumatol 35:1531–1540
Virchow R (1895) Exostosen und Hyperostosen von Extremitäten-knochen des Menschen, im Hinblick auf den Pithecanthropus. Z Ethnol 27:787–793
Volpi N, Dotti MT, Giannini F, Cappelli B, Terrosi Vagnoli P, Federico A (1986) Familial multiple exostoses syndrome: a phacomatosis of bone tissue. Acta Neurol Scand 8:516–521
Wood VE, Sauser D, Mudge D (1985) The treatment of hereditary multiple exostosis of the upper extremity. J Hand Surg [Am] 10:505–513
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Ozaki, T., Kawai, A., Sugihara, S. et al. Multiple osteocartilaginous exostosis. Arch Orthop Trauma Surg 115, 255–261 (1996). https://doi.org/10.1007/BF00439049
Received:
Issue Date:
DOI: https://doi.org/10.1007/BF00439049