Hereditary multiple exostoses management: selective surgery, deformity correction. Dr. Priano, Milan.
Complex surgical management for hereditary condition
Learn about this condition →Removal of symptomatic or risky lesions, preserving others. Often staged procedures over years.
Painful lesions, deforming lesions, compressive lesions, or lesions with suspicious growth.
Variable based on location and number of lesions treated.
Correction of secondary deformities, particularly forearm (radial-ulnar dislocation) and knee.
Progressive deformities with functional limitation.
Immobilization for 4-6 weeks. Physical therapy.
HME management is multifactorial and requires a long-term approach. The goal is preserving function while intervening only when necessary. Complex cases are managed within a multidisciplinary specialist pathway at the Gaetano Pini Institute.
Note: This is an indicative pathway, personalised after surgery. Some elements are relatively stable (goal of the procedure, approximate hospital stay, presence of a cast or brace); others depend on the individual case (weight bearing, range of motion, imaging, sport, hardware removal, follow-up intervals) and on the surgical technique chosen.
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.
Individualized. Generally sports allowed once healed, with possible limitations for contact sports.
Long-term follow-up essential in HME: every 6-12 months throughout growth. Monitor for new symptomatic lesions and malignant transformation.
Recurrence of individual lesions, progression of deformities, rare malignant transformation (1-5% lifetime risk - requires vigilance).
Causes, diagnosis, conservative options and when surgery is considered.
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