J Korean Orthop Assoc.  2010 Feb;45(1):37-43. 10.4055/jkoa.2010.45.1.37.

Deformities of the Lower Extremities in Hereditary Multiple Exostoses

• Jung ST
• Seol JH
• Park JK

• KMID: 2185592
• DOI: http://doi.org/10.4055/jkoa.2010.45.1.37

Abstract

PURPOSE
This study was done to analyze the alignment and deformity of the lower extremity in hereditary multiple exostoses patients.
MATERIALS AND METHODS
We enrolled 32 patients who were diagnosed as having hereditary multiple exostoses (HME) between January 2001 and December 2007. Based on age at diagnosis, we categorized them into 4 groups, A (0-5 years: 6 patients), B (6-10 years: 7 patients), C (11-15 years: 7 patients) and D (>16 years: 12 patients). We measured mechanical axis deviation, This included femorotibial mechanical angle (a), inferolateral angle (b), femoral mechanical proximal anatomical angle (c), femoral mechanical distal anatomical angle (d), distal tibia inferolateral angle (e) and femoral neck-shaft angle (f). We analyzed for differences among the groups of different ages.
RESULTS
The average femorotibial mechanical angles (a) of Groups A/B/C/D were respectively, 178.5degrees/180.3degrees/182.5degrees/183.5degrees (p<0.05). Distal tibia inferolateral angles (e) were respectively, 91.9degrees/93.5degrees/94.2degrees/102.9degrees (p<0.05). The mechanical axis deviation of groups A, B, C, and D, respectively, were 1.7 mm, 6.0 mm, 9.6 mm, and 13.4 mm (p<0.05) on the right side, and 2.9 mm, 7.6 mm, 12.2 mm, and 15.2 mm (p<0.05) on the left side.
CONCLUSION
Patients with HME have a tendency towards having valgus deformities of the knee and ankle joints, which tend to increase with age.

Keyword

hereditary multiple exostoses; deformity of lower extremity

MeSH Terms

Ankle Joint
Axis, Cervical Vertebra
Congenital Abnormalities
Exostoses, Multiple Hereditary
Humans
Knee
Lower Extremity
Tibia

Figure

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  Figure 1 Drawing showing points used to determine the center of the knee.

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  Figure 2 Drawing showing points used to determine the center of the ankle.

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  Figure 3 Drawing showing axes and the angles. Angle a: femorotibial angle, Angle b: medial obliquity of the knee joint, Angle c: femoral mechanical proximal anatomical angle, Angle d: femoral mechanical distal anatomical angle, Angle e: medial obliquity of the ankle, Angle f: femur neck-shaft angle.

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  Figure 4 Drawing showing the anatomical distribution of the lesions.

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