New Consensus Classification Improves Reliability for MHE Forearm Deformity

The CoULD Study Group used a 7-round Delphi process among 15 pediatric hand surgeons to develop a new classification for forearm deformity in multiple hereditary exostoses (MHE), incorporating ulnar variance, radial articular angle, radial head alignment, and osteochondroma size into a 3-tier system. When tested on 101 radiographs from 67 patients, the new classification showed substantially higher interrater reliability (kappa = 0.64 after refinement) compared with the Masada, Gottschalk, and Jo classifications (kappa 0.21-0.43), according to the study. The authors state this provides a more practical framework for longitudinal monitoring of forearm deformities in MHE.

Most relevant for: Clinicians managing longitudinal surveillance of forearm deformity in pediatric patients with multiple hereditary exostoses.

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