Abstract：
Genu valgus is one of the most common limb deformities in hereditary multiple exostoses (HME). However, it is easily concealed and may account for subsequent osteoarthritis of the knee. The knees of 56 patients (33 men and 23 women) with HME were investigated bilaterally. Knee valgus was described by the mechanical axis deviation (MAD), mechanical lateral distal femoral angle (LDFA), and medial proximal tibial angle (MPTA). We investigated sex, age, BMI, total number of palpable osteochondromas, number of radiographic osteochondromas around the knee, forearm deformities, morphology and distribution of lesions, and correlations between these factors and genu valgus. The measurement of LDFA and MPTA was performed to identify the sources of genu valgus deformity. Based on the measurement of the mechanical axis, limbs were classified as genu valgus (n = 22) or normal mechanical axis groups (n = 90). The different severities of the genu valgus patients were classified by MAD. By bivariate logistic regression, genu valgus was significantly associated with more sessile and flared metaphyseal lesions. However, only the number of flared metaphyseal lesions had a significant influence on the severity of genu valgus. By analyzing the LDFA and MPTA, it was found that abnormalities of both proximal tibia and distal femur play important roles in genu valgus. Early detection of sessile and flared metaphyseal knee lesions in patients with HME can contribute to early intervention of genu valgus. Level of relevance: Level 2.
摘要：
Genu外翻是遗传性多发性外生体（HME）中最常见的肢体畸形之一。然而,它很容易被掩盖，并可能导致随后的膝关节骨关节炎。对56例HME患者（33例男性和23例女性）的膝盖进行了双侧调查。膝关节外翻由机械轴偏差(MAD)描述，机械股骨远端外侧角（LDFA），和胫骨近端内侧角（MPTA）。我们调查了性,年龄,BMI,可触知的骨软骨瘤总数，膝关节周围的影像学骨软骨瘤数量，前臂畸形,病变的形态和分布，以及这些因素与外翻之间的相关性。进行LDFA和MPTA的测量以确定外翻畸形的来源。基于对机械轴的测量，四肢分为外翻（n=22）或正常机械轴组（n=90）。根据MAD对膝外翻患者的不同严重程度进行分类。通过双变量逻辑回归，外翻与更多的无柄和张开的干phy端病变显着相关。然而,只有张开的干phy端病变的数量对外翻的严重程度有重大影响。通过分析LDFA和MPTA,发现胫骨近端和股骨远端的异常在外翻中起重要作用。HME患者早期发现无柄和喇叭形干phy端膝关节病变有助于早期干预外翻。相关级别：2级。
