gms | German Medical Science

German Congress of Orthopaedics and Traumatology (DKOU 2016)

25.10. - 28.10.2016, Berlin

Evaluation of forearm abnormalities; clinical and cosmetic results of surgical treatment in patients with multiple osteochondromas (MO)

Meeting Abstract

  • presenting/speaker Mark Flipsen - Orthopaedic Department, OLVG, Amsterdam, Netherlands
  • Marianne Koolen - Orthopaedic Department, OLVG, Amsterdam, Netherlands
  • Vanessa Scholtes - Orthopaedic Department, OLVG, Amsterdam, Netherlands
  • John Ham - Orthopaedic Department, OLVG, Amsterdam, Netherlands
  • Konrad Mader - Orthopädie, Unfall- und Wirbelsäulenchirurgie, Sektion Obere Extremität, Hamburg, Germany

Deutscher Kongress für Orthopädie und Unfallchirurgie (DKOU 2016). Berlin, 25.-28.10.2016. Düsseldorf: German Medical Science GMS Publishing House; 2016. DocWI23-30

doi: 10.3205/16dkou116, urn:nbn:de:0183-16dkou1168

Published: October 10, 2016

© 2016 Flipsen et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.


Outline

Text

Objectives: This study aimed to retrospectively describe and assess the results of surgical treatment for forearm osteochondromas and deformities in a large cohort of MO patients. Secondary aim was to evaluate patient general and cosmetic satisfaction, radiologic results and quality of life.

Methods: 124 forearms in 97 MO patients were surgically treated for forearm osteochondromas or deformities between 2002 and 2015 at one institution. Range of motion of forearm, elbow, and wrist at pre- (T0) and postoperative at two (T1), five (T2) and ten (T3) years were retrospectively reviewed. In a cross-sectional part a questionnaire focusing on patient general and cosmetic satisfaction, pre- and postoperative pain, and quality of life was sent to all patients. Patients were grouped by indication for surgery (I: pain, II: functional impairment, III: both). The radial articular angle (RAA), carpal slip, ulnar variance and radial bow were measured pre- and postoperative.

Results and Conclusion: 72 patients (74%) completed the questionnaires. Median follow-up period was 41(7.5-139) months. Surgical procedures performed included excision of osteochondromas, ulnar lengthening, radial corrective osteotomy, excision of radial head, or combinations. In group I VAS score for pain significantly decreased after surgery (p<0.001). In group II function increased significantly and was retained over longer follow-up periods (p<0.004 for supination, pronation palmar flexion, and radial deviation at T3). In comparison with the national cohort, the present adult MO population scored significantly lower on four dimensions of the RAND-36. Quality of life was equivalent to the national MO cohort, as reviewed by Goud et al (Goud, 2012). Overall, MO patients were satisfied with the surgical procedure performed, but quality of life was due to MO-related problems significantly affected. No improvements were found for cosmetic complaints. All radiologic parameters did improve substantially.

On the basis of our findings, the assessment for indication as stated is justifiable. Significant improvements were made in pain complaints and range of motion by excision of osteochondromas or corrective procedures in patients with forearm deformities in MO. Cosmetic complaints should not be solely used as an indication for surgery. As the quality of life in MO patients is clearly affected, forearm involvement has a significant contribution to the comprehensive issues MO entails.