Hinge positioning method of Ilizarov apparatus in correcting radial head luxation caused by multiple hereditary exostoses
Rui Zhang*
, Xiaoyu Wang*, Shenghe Liu, Hongjiang Ruan, Jia Xu, Qinglin Kang
Department of Orthopedics, Shanghai Jiao Tong University affiliated Sixth People’s Hospital, Shanghai, China
Keywords: Dislocation; hinge positioning; Ilizarov fixator; multiple hereditary exostoses; radial head; ulnar osteotomy.
Abstract
Objectives: In this study, we present a specified hinge positioning method to achieve satisfying and steerable lengthening and angulation to correct forearm multiple hereditary exostoses (MHE) combined with severe radiocapitellar joint dislocation using Ilizarov ring fixators.
Patients and methods: Between January 2014 and December 2018, a total of 30 forearms of 23 patients (11 males, 12 females; mean age: 18.3±6.8 years; range, 8 to 35 years) who suffered from type IIa (n=2) or IIb (n=28) MHE with severe radiocapitellar joint luxation were retrospectively analyzed. All patients were treated with Ilizarov external fixators with our specified hinge positioning method. Range of motion of the elbow, forearm and wrist and Visual Analog Scale (VAS), as well as Disabilities of Arm, Shoulder, and Hand (DASH) score, and radiological parameters, including radial articular angle (RAA), ulnar variance (UV) and carpi slip (CS), were recorded preoperatively and at final follow-up and were compared.
Results: Clinical and radiological outcomes were evaluated. Range of motion of the elbow, forearm and wrist, VAS, DASH and radiological features, including RAA, CS, and UV were significantly improved, except for range of motion of the forearm supination. Temporary nail track infection was seen in two of the forearms and was controlled with oral antibiotics. None of the patients developed radial head dislocation again.
Conclusion: Clinical and radiological outcomes of this novel hinge positioning method are satisfactory in treating MHE with severe radial head dislocation, and this method can be an alternative treatment for MHE by setting a milestone for accurate radiocapitellar joint reduction.
Citation: Zhang R, Wang X, Liu S, Ruan H, Xu J, Kang Q. Hinge positioning method of Ilizarov apparatus in correcting radial head luxation caused by multiple hereditary exostoses. Jt Dis Relat Surg 2022;33(1):40-50.
* Co-First Authors
The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.
The authors received financial support from National Natural Science Foundation of China (No. 82072421) for the research of this article.