Rapidly acquired valgus deformity of the knee after osteochondroma resection in multiple hereditary exostoses pediatric patients: A report of two cases

Patients with multiple hereditary exostoses (MHE) often develop leg length discrepancies and limb alignment deformity around the knee as part of the natural course of the disease. Limb alignment deformity occurring post-resection of an osteochondroma has been described in one case report and only pe...

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Main Authors: Alexandra H. Aitchison, BS, David Alcoloumbre, MD, Ana C. Belzarena, MD, John S. Blanco, MD
Format: Article
Language:English
Published: Elsevier 2022-01-01
Series:Radiology Case Reports
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S1930043321007524
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author Alexandra H. Aitchison, BS
David Alcoloumbre, MD
Ana C. Belzarena, MD
John S. Blanco, MD
author_facet Alexandra H. Aitchison, BS
David Alcoloumbre, MD
Ana C. Belzarena, MD
John S. Blanco, MD
author_sort Alexandra H. Aitchison, BS
collection DOAJ
description Patients with multiple hereditary exostoses (MHE) often develop leg length discrepancies and limb alignment deformity around the knee as part of the natural course of the disease. Limb alignment deformity occurring post-resection of an osteochondroma has been described in one case report and only pertaining to the proximal medial tibia location. Here we describe the case of 2 patients with MHE, a 7-year-old female who underwent resection of distal femur and proximal tibia osteochondromas and a 9-year-old female who had a distal femur osteochondroma resected. Both patients developed rapidly progressive valgus knee deformity requiring surgical intervention. Excision of osteochondromas near the physis of a skeletally immature patient can cause overgrowth from the involved side of the growth plate resulting in a rapidly progressing unilateral coronal plane deformity. Surgeons should be aware of this potential complication and closely follow growing patients with serial alignment radiographs and counsel the family regarding the potential of acquired limb deformity and subsequent surgeries.
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spelling doaj.art-bc7f196150a44464bf3b47caddd15e252022-12-21T19:26:27ZengElsevierRadiology Case Reports1930-04332022-01-01171201207Rapidly acquired valgus deformity of the knee after osteochondroma resection in multiple hereditary exostoses pediatric patients: A report of two casesAlexandra H. Aitchison, BS0David Alcoloumbre, MD1Ana C. Belzarena, MD2John S. Blanco, MD3Division of Pediatric Orthopedic Surgery, Hospital for Special Surgery, 535 E 70th st, New York, NY, 10021, USADivision of Pediatric Orthopedic Surgery, Hospital for Special Surgery, 535 E 70th st, New York, NY, 10021, USADepartment of Orthopedic Oncology Miami Cancer Institute, 8900 N Kendall Dr, Miami, FL 33176, USADivision of Pediatric Orthopedic Surgery, Hospital for Special Surgery, 535 E 70th st, New York, NY, 10021, USA; Corresponding author.Patients with multiple hereditary exostoses (MHE) often develop leg length discrepancies and limb alignment deformity around the knee as part of the natural course of the disease. Limb alignment deformity occurring post-resection of an osteochondroma has been described in one case report and only pertaining to the proximal medial tibia location. Here we describe the case of 2 patients with MHE, a 7-year-old female who underwent resection of distal femur and proximal tibia osteochondromas and a 9-year-old female who had a distal femur osteochondroma resected. Both patients developed rapidly progressive valgus knee deformity requiring surgical intervention. Excision of osteochondromas near the physis of a skeletally immature patient can cause overgrowth from the involved side of the growth plate resulting in a rapidly progressing unilateral coronal plane deformity. Surgeons should be aware of this potential complication and closely follow growing patients with serial alignment radiographs and counsel the family regarding the potential of acquired limb deformity and subsequent surgeries.http://www.sciencedirect.com/science/article/pii/S1930043321007524Multiple hereditary exostosisMHEKneeFemurTibiaHemiepiphysiodesis
spellingShingle Alexandra H. Aitchison, BS
David Alcoloumbre, MD
Ana C. Belzarena, MD
John S. Blanco, MD
Rapidly acquired valgus deformity of the knee after osteochondroma resection in multiple hereditary exostoses pediatric patients: A report of two cases
Radiology Case Reports
Multiple hereditary exostosis
MHE
Knee
Femur
Tibia
Hemiepiphysiodesis
title Rapidly acquired valgus deformity of the knee after osteochondroma resection in multiple hereditary exostoses pediatric patients: A report of two cases
title_full Rapidly acquired valgus deformity of the knee after osteochondroma resection in multiple hereditary exostoses pediatric patients: A report of two cases
title_fullStr Rapidly acquired valgus deformity of the knee after osteochondroma resection in multiple hereditary exostoses pediatric patients: A report of two cases
title_full_unstemmed Rapidly acquired valgus deformity of the knee after osteochondroma resection in multiple hereditary exostoses pediatric patients: A report of two cases
title_short Rapidly acquired valgus deformity of the knee after osteochondroma resection in multiple hereditary exostoses pediatric patients: A report of two cases
title_sort rapidly acquired valgus deformity of the knee after osteochondroma resection in multiple hereditary exostoses pediatric patients a report of two cases
topic Multiple hereditary exostosis
MHE
Knee
Femur
Tibia
Hemiepiphysiodesis
url http://www.sciencedirect.com/science/article/pii/S1930043321007524
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