Radiographic Outcomes of Hemiepiphyseal Stapling for Distal Radius Deformity Due to Multiple Hereditary Exostoses.

Abstract

Multiple hereditary exostoses (MHE) affect the distal forearm in 30% to 60% of patients with this condition. Many surgical interventions have been described, but treatment is controversial. We present the radiographic results of low risk, minimally invasive hemiepiphyseal stapling of the distal radius to correct the joint angulation caused by MHE through growth modulation. A retrospective review was performed on 18 forearms affected by MHE that underwent radial hemiepiphyseal stapling with follow-up of ≥2 years. The radial articular angle, carpal slip, ulnar tilt, lunate subsidence, and metaphyseal epiphyseal angle were measured on preoperative and final postoperative radiographs and compared. Statistically significant (P<0.05) improvements were found in 4 of 5 measurements, including the radial articular angle, carpal slip, ulnar tilt, and metaphyseal epiphyseal angle. No statistical difference was found in lunate subsidence (P=0.84). Hemiepiphyseal stapling of the radial side of the distal radius is a simple and effective method for correcting the radiographic deformity of the distal radius and may be an attractive option for the treatment of the distal radial deformity that is characteristic of the disease. Level IV—therapeutic case series.