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Journal of Bone and Joint Surgery - British Volume, Vol 87-B, Issue 4, 540-543.
doi: 10.1302/0301-620X.87B4.15141  
Copyright © 2005 by British Editorial Society of Bone and Joint Surgery
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Ulnar focal cortical indentation

A PREVIOUSLY UNRECOGNISED FORM OF ULNAR DYSPLASIA

K. Kazuki, MD, Orthopaedic Surgeon, Associate Professor

Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahimachi, Abeno-ku, Osaka 545-8585, Japan.

K. Hiroshima, MD, Orthopaedic Surgeon, Professor and Director

Department of Orthopaedic Surgery

K. Kawahara, MD, Pathologist

Department of Pathology, Osaka National Hospital, 2-1-14 Hoenzaka, Chuo-ku, 540-0006, Japan.

Correspondence should be sent to Dr K. Kazuki; e-mail: kkazuki{at}med.osaka-cu.ac.jp

Deformity of the forearm due to growth disturbance of the ulna occurs in a number of conditions such as ulnar deficiency, multiple exostoses, and neurofibromatosis. We report a previously unrecognised form, caused by focal cortical indentation.

We have treated five children with this condition, three girls and two boys; the mean age at presentation was 5 years (2 to 8). The deformity was first recognised about the age of two years, and progressed gradually. The radiological findings were the same in all cases. The focal cortical indentation was seen at the distal end of the ulna with anteromedial bowing and dysplasia. The radial head was dislocated posterolaterally. In one patient the histological findings at the site of indentation were of a fold of tissue resembling periosteum, which interfered with enchondral ossification. Treatment by ulnar lengthening using an external fixator and osteotomy which corrected both the ulnar deformity and reduced the dislocated radial head in two cases gave the best results.






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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General