Journal of pediatric orthopedics. Part B
July 28, 2026 · via Europe PMC
Radiographic outcomes of a treatment approach for lower leg deformities in patients with hereditary multiple exostoses.
Sawamura K, Matsushia M, Mishima K, Imagama S.
AI summary — for doctors, generated from the abstract only
Tension-band plating corrected both angular deformity and leg length discrepancy in skeletally mature follow-up of children with hereditary multiple exostoses.
What was studied
A retrospective review of 25 children (50 limbs) with HME followed to skeletal maturity, 17 of whom underwent tension-band plating (27 limbs, 60 physes) for angular deformity and predicted LLD.
Key findings
- Hip-knee-ankle angle improved from 7.8° to 2.7°, with 92% of limbs reaching mechanical axis Zone 1
- LLD improved from 17.6 to 5.6 mm (P < 0.01) at 0.47 mm/month
- Outcomes were excellent in 12, good in 11 and fair or poor in 2 patients
- No major complications; multisite and staged surgeries were often needed
Clinical relevance
Suggests tension-band plating may address both alignment and length in HME, though based on a small retrospective single-institution cohort.
Who should care
Limitations
Small retrospective series without a comparison group.
Guided growth with tension-band plates can comprehensively correct HME lower limb deformities with careful planning.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
Hereditary multiple exostoses (HME) represent a rare skeletal disorder characterized by multiple osteochondromas, often leading to angular deformities in the lower limbs as well as leg length discrepancy (LLD), managed with tension band plates (TBP) for deformity correction. However, the utility of both angular deformity and LLD in HME has not been comprehensively evaluated. In this study, we retrospectively reviewed 25 pediatric patients with HME who visited our institution and reached skeletal maturity between 2012 and 2024, assessing a total of 50 limbs. Surgical indications included patients aged greater than 10 years with an open growth plate, predicted LLD of greater than or equal to 20 mm at the skeletal maturity, and a mechanical axis zone (MAZ) greater than or equal to Zone 2. We categorized the outcomes into four groups: excellent [LLD < 10 mm; mechanical axis percentage (%MA) ≤ ±25%], good (LLD < 15 mm; %MA ≤ ±50%), fair (LLD < 20 mm or at least one limb classified as %MA ≤ ±100%), and poor (worse than the previous categories). We used paired t -tests for statistical analyses. Among the 17 surgically treated patients, TBP was performed on 27 limbs and 60 physes. In most cases, multisite and staged surgeries were required. Angular deformities improved significantly, with the mean hip-knee-ankle angle reduced from 7.8 to 2.7° (lower extremity < 0.01), and 92% of limbs achieved MAZ Zone 1. LLD was corrected from 17.6 to 5.6 mm ( P < 0.01) at an average correction rate of 0.47 mm/month. The final outcomes were excellent, good, and fair or poor in 12, 11, and 2 patients, respectively. Major complications were not observed. TBP treatment is effective in correcting both angular deformity and LLD in patients with HME, offering a minimally invasive strategy for comprehensive correction of this complex skeletal dysplasia. Careful surgical planning and timing are essential and staged multisite procedures are often required.
DOI
10.1097/bpb.0000000000001342
PMID
41766296
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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