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Orthopädische Behandlung bei multiplen kartilaginären Exostosen

Orthopedic treatment of multiple cartilaginous exostosis

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Zusammenfassung

Die multiple hereditäre Exostosenerkrankung (MHE) wird autosomal-dominant vererbt und tritt mit einer Inzidenz von etwa 1:50.000 auf. Die routinemäßige Resektion asymptomatischer Exostosen ist unnötig. Durch einzelne Exostosen verursachte lokale Probleme, Irritationen benachbarter Gefäße und Nerven, assoziierte Wachstumsstörungen und Deformitäten sowie ein bestehender Malignitätsverdacht machen jedoch entsprechende orthopädische Operationen notwendig. Das Spektrum reicht von der isolierten Exostosenresektion über klassische wachstumslenkende Maßnahmen bis hin zu neurochirurgischen oder gefäßchirurgischen Eingriffen. Ziel dieser Übersichtsarbeit ist es, die Notwendigkeit und das therapeutische Spektrum der operativen Behandlung im Rahmen der MHE anhand einzelner Kasuistiken zu beschreiben.

Abstract

Multiple hereditary exostoses (MHE) is an autosomal dominant inherited genetic condition with an incidence of approximately 1:50,000. The routine resection of asymptomatic exostoses is unnecessary. Indications for surgery are pain, cosmetic complaints, vascular and neurological complications, abnormal growth and suspected malignancy. The spectrum ranges from resection of isolated exostoses through classical growth deviation measures up to neurological or even vascular surgical interventions. This article focuses on orthopedic surgery for the treatment of MHE. The main surgical procedures are illustrated by case studies.

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Literatur

  1. Al-Hadidy AM, Al-Smady MM, Haroun AA et al (2007) Hereditary multiple exostoses with pseudoaneurysm. Cardiovasc Intervent Radiol 30(3):537–540

    Article  PubMed  Google Scholar 

  2. Ashraf A, Larson AN, Ferski G et al (2013) Spinal stenosis frequent in children with multiple hereditary exostoses. Child Orthop 7(3):183–194

    Article  Google Scholar 

  3. Clement ND, Ng CE, Porter DE (2011) Shoulder exostoses in hereditary multiple exostoses: probability of surgery and malignant change. J Shoulder Elbow Surg 20(2):290–294

    Article  PubMed  Google Scholar 

  4. Garrison RC, Unni KK, McLeod RA et al (1982) Chondrosarcoma arising in osteochondroma. Cancer 49:1890–1897

    Article  CAS  PubMed  Google Scholar 

  5. Göçmen S, Topuz AK, Atabey C et al (2014) Peripheral nerve injuries due to osteochondromas: analysis of 20 cases and review of the literature. J Neurosurg 120(5):1105–1112

    Article  PubMed  Google Scholar 

  6. Nawata K, Teshima R, Minamizaki T et al (1995) Knee deformities in multiple hereditary exostoses. A longitudinal radiographic study. Clin Orthop Relat Res 313:194–199

    PubMed  Google Scholar 

  7. Perez-Burkhardt JL, Gómez Castilla JC (2003) Posttraumatic popliteal pseudoaneurysm from femoral osteochondroma: case report and review of the literature. J Vasc Surg 37(3):669–671

    Article  PubMed  Google Scholar 

  8. Peterson HA (1989) Multiple hereditary osteochondromata. Clin Orthop 239:222–230

    PubMed  Google Scholar 

  9. Pritchett JW (1986) Lengthening the ulna in patients with hereditary multiple exostoses. J Bone Joint Surg Br 68(4):561–565

    CAS  PubMed  Google Scholar 

  10. Roach JW, Klatt JW, Faulkner ND (2009) Involvement of the spine in patients with multiple hereditary exostoses. J Bone Joint Surg 91(8):1942–1948

    Article  PubMed  Google Scholar 

  11. Rupprecht M, Mladenov K, Stücker R (2010) Posttraumatic popliteal pseudoaneurysm caused by a femoral osteochondroma. J Pediatr Orthop B 19(4):341–343

    Article  PubMed  Google Scholar 

  12. Rupprecht M, Spiro A, Schlickewei C et al (2014) Rebound of ankle valgus deformity in patients with hereditary multiple exostosis. J Ped Orthop (im Druck)

  13. Rupprecht M, Spiro AS, Rueger JM et al (2011) Temporary screw epiphyseodesis of the distal tibia: a therapeutic option for ankle valgus in patients with hereditary multiple exostosis. J Pediatr Orthop 31(1):89–94

    Article  PubMed  Google Scholar 

  14. Saad NE, Briones AJ, Rhodes J et al (2007) Pseudoaneurysm of a genicular branch of the popliteal artery and deep venous thrombosis: an unusual presentation of an osteochondroma. J Vasc Interv Radiol 18(4):581–583

    Article  PubMed  Google Scholar 

  15. Schmale GA, Conrad EU III, Raskind WH (1994) The natural history of hereditary multiple exostoses. J Bone Joint Surg Am 76(7):986–992

    CAS  PubMed  Google Scholar 

  16. Shapiro F, Simon S, Glimcher MJ (1979) Hereditary multiple exostoses: anthropometric, roentgenographic, and clinical aspects. J Bone Joint Surg Am 61-A:5–24

  17. Stieber JR, Dormans JP (2005) Manifestations of hereditary multiple exostoses. J Am Acad Orthop Surg 13(2):110–120

    PubMed  Google Scholar 

  18. Streitbuerger A, Hardes J, Gebert C et al (2006) Cartilage tumours of the bone. Diagnosis and therapy. Orthopade 35(8):871–881

    Article  CAS  PubMed  Google Scholar 

  19. Trotter D, Zindrick M, Ibrahim K (1984) An unusual presentation of an osteochondroma. Report of a case. J Bone Joint Surg Am 66:299–301

    CAS  PubMed  Google Scholar 

  20. Vasseur MA, Fabre O (2000) Vascular complications of osteochondromas. J Vasc Surg 31(3):532–538

    Article  CAS  PubMed  Google Scholar 

  21. Watson LW, Torch MA (1993) Peroneal nerve palsy secondary to compression from an osteochondroma. Orthopedics 16:707–710

    CAS  PubMed  Google Scholar 

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Einhaltung ethischer Richtlinien

Interessenkonflikt. M. Rupprecht, P. Kunkel, K. Ridderbusch und R. Stücker geben an, dass kein Interessenkonflikt besteht. Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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Authors and Affiliations

  1. Abteilung für Kinderorthopädie, Altonaer Kinderkrankenhaus, Bleickenallee 38, 22763, Hamburg, Deutschland

    M. Rupprecht, K. Ridderbusch & R. Stücker

  2. Klinik für Orthopädie, Univ.-Klinikum Hamburg-Eppendorf, Hamburg, Deutschland

    M. Rupprecht, K. Ridderbusch & R. Stücker

  3. Abteilung für Kinderneurochirurgie, Altonaer Kinderkrankenhaus, Hamburg, Deutschland

    P. Kunkel

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  1. M. Rupprecht
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  2. P. Kunkel
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  3. K. Ridderbusch
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  4. R. Stücker
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Correspondence to M. Rupprecht.

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Rupprecht, M., Kunkel, P., Ridderbusch, K. et al. Orthopädische Behandlung bei multiplen kartilaginären Exostosen. Monatsschr Kinderheilkd 162, 989–995 (2014). https://doi.org/10.1007/s00112-013-3027-z

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  • DOI: https://doi.org/10.1007/s00112-013-3027-z

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