Forearm Hereditary Multiple Exostosis: A Retrospective Case Series Study.

Background Hereditary multiple exostosis (HME) is a significantly rare genetic condition with benign chondrogenic lesions affecting long bones. Forearm involvement is relatively common, with varied treatment modalities reported. Here we describe our experience with HME. The study is the first of its kind to be conducted in the Middle East and Saudi Arabia. Methods A retrospective medical record-based case review was carried out on patients with forearm HME operated from 2006 to 2022 at our institution. Patient demographics, clinical presentation, management, outcome, Masada scale, and radiological outcomes were analysed.  Results Ten patients (12 affected forearms) with HME were included. The average age of those undergoing surgery was 12.7 ± 5.13 years, and the average length of follow-up was 62.25 months. Most patients (n = 5, 50%) had Masada type 1 (Type I indicates radial head not displaced, primary exostosis from the distal region of the ulna, ulna relatively short, radius bending). Five (50%) underwent radial head resection. The majority of the patients (n = 8, 80%) had no complications or recurrence. Two patients developed recurrence; the first one developed recurrent radial bone deformity and dislocation of the radial head and the second, who underwent excision with an iliac crest bone graft application, developed osteolysis of the bone graft with recurrent deformity. Conclusion HME is typically managed primarily by excision of the lesion at skeletal maturity and annual check-up and radiological follow-up. If a secondary procedure is needed in future, simple excision of the dislocated radial head would be the most feasible approach. Due to the rarity of the illness and limited literature, further studies are still required to optimize the outcome in children with HME.

Causes of hospitalization in sickle cell diseased children in western region of Saudi Arabia. A single center study.

OBJECTIVES: To highlight the causes of hospitalization among sickle cell diseased (SCD) children in Al-Madinah Al-Munawarah, Saudi Arabia. METHODS: A retrospective study conducted at the Maternity and Children's Hospital, Al-Madinah Al-Munawarah, Saudi Arabia. A data of 739 SCD children admitted to the hematology/oncology unit between October 2010 and September 2015 were collected. The collected data were analyzed using an independent t test and a Chi square test as appropriate. RESULTS: Approximately 49% of the studied children were presented by acute painful crisis. Acute chest syndrome was reported in 20.9%. Infection was the cause of admission in 17.5%, and acute anemia was reported in 8.1% of the studied patients. No significant difference of the reported clinical manifestations by patients' gender. Children aged <12 years showed significantly high frequency of acute chest syndrome (ACS) (26.5%), while acute painful crisis (66.4%) was significantly more frequent among children aged ≥12 years. CONCLUSION: This study revealed high rate of hospitalization of SCD children because of acute painful crisis, ACS, infection, and anemia. These admissions causes could potentially be continuously assessed to minimize the rate of hospitalization.