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    Surgery: Hereditary Multiple Exostoses (HME)

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

    Complex surgical management for hereditary condition

    Learn about this condition →

    Surgical Techniques

    Selective Exostosis Removal

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

    When it is used

    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.

    When it is used

    Progressive deformities with functional limitation.

    Recovery

    Immobilization for 4-6 weeks. Physical therapy.

    Postoperative Overview

    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.

    Recovery Pathway (indicative)

    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.

    1. Hospital stay

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

    2. First weeks

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

    3. Second month

      Progressive rehabilitation. Follow-up imaging.

    4. Third month

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

    5. Return to sport

      Individualized. Generally sports allowed once healed, with possible limitations for contact sports.

    6. Follow-up

      Long-term follow-up essential in HME: every 6-12 months throughout growth. Monitor for new symptomatic lesions and malignant transformation.

    Possible Complications

    Recurrence of individual lesions, progression of deformities, rare malignant transformation (1-5% lifetime risk - requires vigilance).

    For parents

    Hereditary Multiple Exostoses (HME): condition information page

    Causes, diagnosis, conservative options and when surgery is considered.

    Questions about this surgery?

    Book a consultation to discuss your child's specific case.

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