Table 5. [Treatment of Manifestations in Individuals with Hereditary Multiple Osteochondromas]. - GeneReviews®

Manifestation/ Concern	Treatment	Considerations/Other
Asymptomatic osteochondromas	Require no therapy in absence of clinical problems	Though uncomplicated resection of osteochondromas in growing children is frequently reported, ¹ it is asooc w/a theoretic risk of growth abnormality.
Painful osteochondromas w/o bony deformity	Simple surgical excision may slow growth disturbance & improve cosmesis.	Must incl cartilage cap & overlying perichondrium to avoid recurrence
Angular deformities of forearm	May incl excision of osteochondromas, corrective osteotomies, &/or ulnar lengthening procedures to improve pronation, supination, & forearm alignment ² Adults w/untreated forearm deformities describe few functional limitations.	Waiting to resect osteochondromas until they have migrated away from the physis would ↓ risk of injury to physis, & could ↓ risk of recurrence of lesions, ³ but many studies suggest that early (age <10 yrs) treatment of forearm deformities via resection of distal osteochondromas may ↓ proportionate shortening & bowing of forearm ⁴ as well as ankle deformity. ⁵
Angular misalignment of lower limbs	May be treated w/hemiepiphysiodeses (or osteotomies) at distal femur, proximal tibia, or distal tibia ⁶
Leg-length inequalities	Discrepancy >2.5 cm is often treated w/epiphysiodesis (growth plate arrest) of longer leg.
Tibio-talar tilt	Early surgical treatment may prevent or ↓ incidence of late deterioration of ankle function. ⁷	Long-term follow-up studies are needed.
Sarcomatous degeneration	Surgical resection	Adjuvant radiotherapy & chemotherapy are controversial for secondary chondrosarcoma but often used w/secondary osteosarcoma.

Manifestation/
Concern

Treatment

Considerations/Other

Asymptomatic osteochondromas

Require no therapy in absence of clinical problems

Though uncomplicated resection of osteochondromas in growing children is frequently reported, ¹ it is asooc w/a theoretic risk of growth abnormality.

Painful osteochondromas w/o bony deformity

Simple surgical excision may slow growth disturbance & improve cosmesis.

Must incl cartilage cap & overlying perichondrium to avoid recurrence

Angular deformities of forearm

May incl excision of osteochondromas, corrective osteotomies, &/or ulnar lengthening procedures to improve pronation, supination, & forearm alignment ²
Adults w/untreated forearm deformities describe few functional limitations.

Waiting to resect osteochondromas until they have migrated away from the physis would ↓ risk of injury to physis, & could ↓ risk of recurrence of lesions, ³ but many studies suggest that early (age <10 yrs) treatment of forearm deformities via resection of distal osteochondromas may ↓ proportionate shortening & bowing of forearm ⁴ as well as ankle deformity. ⁵

Angular misalignment of lower limbs

May be treated w/hemiepiphysiodeses (or osteotomies) at distal femur, proximal tibia, or distal tibia ⁶

Leg-length inequalities

Discrepancy >2.5 cm is often treated w/epiphysiodesis (growth plate arrest) of longer leg.

Tibio-talar tilt

Early surgical treatment may prevent or ↓ incidence of late deterioration of ankle function. ⁷

Long-term follow-up studies are needed.

Sarcomatous degeneration

Surgical resection

Adjuvant radiotherapy & chemotherapy are controversial for secondary chondrosarcoma but often used w/secondary osteosarcoma.

From: Hereditary Multiple Osteochondromas

GeneReviews^® [Internet].

Adam MP, Feldman J, Mirzaa GM, et al., editors.

Seattle (WA): University of Washington, Seattle; 1993-2024.

GeneReviews® chapters are owned by the University of Washington. Permission is hereby granted to reproduce, distribute, and translate copies of content materials for noncommercial research purposes only, provided that (i) credit for source (http://www.genereviews.org/) and copyright (© 1993-2024 University of Washington) are included with each copy; (ii) a link to the original material is provided whenever the material is published elsewhere on the Web; and (iii) reproducers, distributors, and/or translators comply with the GeneReviews® Copyright Notice and Usage Disclaimer. No further modifications are allowed. For clarity, excerpts of GeneReviews chapters for use in lab reports and clinic notes are a permitted use.

For more information, see the GeneReviews® Copyright Notice and Usage Disclaimer.

For questions regarding permissions or whether a specified use is allowed, contact: ude.wu@tssamda.

NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.