Ulnar lengthening for forearm deformities in hereditary multiple exostoses: a systematic review and meta-analysis (2015–2025)

Abstract Background Hereditary multiple exostoses (HME) is an autosomal dominant skeletal disorder frequently associated with progressive forearm deformities, including ulnar shortening, radial bowing, and radial head dislocation. Ulnar lengthening using distraction osteogenesis has become the principal surgical strategy; however, outcomes, techniques, and complication profiles vary across studies. This systematic review and meta-analysis synthesize contemporary evidence on radiographic correcti