Surgery: Hereditary Multiple Exostoses (HME)

Hereditary multiple exostoses management: selective surgery, deformity correction. Dr. Priano, Milan.

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Complex surgical management for hereditary condition

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Surgical Techniques

Selective Exostosis Removal

Removal of symptomatic or risky lesions, preserving others. Often staged procedures over years.

Indication

Painful lesions, deforming lesions, compressive lesions, or lesions with suspicious growth.

Recovery

Variable based on location and number of lesions treated.

Corrective Osteotomies

Correction of secondary deformities, particularly forearm (radial-ulnar dislocation) and knee.

Indication

Progressive deformities with functional limitation.

Recovery

Immobilization for 4-6 weeks. Physical therapy.

Postoperative Overview

HME management is multifactorial requiring a long-term approach. The goal is preserving function while intervening only when necessary. We treat complex cases with advanced methods at Gaetano Pini Institute, the regional reference center for pediatric orthopaedics.

Detailed Recovery Timeline

Note: The timeline below is a general baseline. The actual postoperative course varies depending on the specific surgical technique chosen (see procedures above).

Variable: day-surgery for single lesion, 1-2 nights for osteotomies.

Dependent on procedure type and location. Detailed protocol provided for each surgery.

Progressive rehabilitation. Follow-up imaging.

Return to activities based on specific procedure. Some deformity corrections require longer rehabilitation.