Treatment of ulnar clubhand in children with exostotic osteochondrodysplasia: guided growth as an alternative to corrective osteotomy

Introduction. Multiple hereditary exostatic chondrodysplasia (MHEC) is an orphan disease that requires constant orthopedic support for patients during the growth process. More than 35% of MHEC children require surgical treatment for progressive ulnar clubhand (UC). Guided-growth technology makes it possible to correct deformity without crossing the bone. The aim of the work: to increase the effectiveness of surgical treatment of ulnar clubhand in MHEC children by optimizing the choice of tactics between the method of hemiepiphysiodesis of the radius and various variants of osteotomies of the forearm bones.

Materials and methods. Thirty UC children were examined against the background of MHEC, which were observed in the neuro-orthopaedic department from 2018 to 2025. All patients were divided into 2 groups according to surgical treatment methods: group 1 consisted of 15 children (19 forearms) treated with guided growth technology, group 2 consisted of 15 patients (15 forearms) treated with osteotomies. All parameters were evaluated before and 21 ± 6 months after surgery.

Results. In patients of the controlled growth group, all parameters showed statistically significant changes before and after surgery (p < 0.01). When comparing the results of operations between groups of patients, the key parameter was the wrist joint angle (difference 7.75°; p < 0.0001), which showed greater importance in children of the controlled growth group. The remaining postoperative parameters did not differ significantly in patients of different groups.

Conclusion. The use of controlled growth technology makes it possible to correct both axial deformity and the difference in the length of the forearm bones in patients, which prevents the formation of severe deformities and reduces the need for osteotomies in the future. Performing osteotomies with various types of internal and external fixation is certainly the method of choice for correcting severe deformities with dislocation of the head of the radius.

Contribution:
Petel’guzov A.A., Zubkov P.A. — concept and design of the study;
Petelguzov A.A., Zubkov P.A. — collection and processing of the material;
Zubkov P.A., Pimbursky I.P. — statistical processing of the material;
Petel’guzov A.A., Zubkov P.A., Zherdev K.V., Chelpachenko O.B. — writing the text;
Zherdev K.V., Butenko A.S., Chelpachenko O.B., Pimbursky I.P. — editing the text.
All co-authors — approval of the final version of the article, responsibility for the integrity of all parts of the article.

Acknowledgment. The study had no sponsorship.

Conflict of interest. The authors declare no conflict of interest.

Received: October 14, 2025
Accepted: November 27, 2025
Published: December 25, 2025

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