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PubMed This is a summary of 14 peer-reviewed journal articles Updated
Orthopedics

Correcting and Managing Bone Growth Challenges

At a Glance

Orthopedic treatment for Ollier disease focuses on correcting limb length differences and bone deformities using distraction osteogenesis. Treatments include external fixators for younger children and internal motorized nails for adults, alongside careful management of pathological bone fractures.

Managing the physical effects of Ollier disease requires a collaborative, long-term partnership with an orthopedic specialist. While the condition affects how bones grow, modern surgical techniques offer powerful tools to correct deformities, equalize limb lengths, and keep patients mobile and active.

Correcting Deformities and Length

The primary goal of orthopedic treatment is to address limb length discrepancies (one limb being shorter than the other) and angular deformities (like knock-knees or bowed arms) [1][2]. The most common approach for this is distraction osteogenesis—a process where a bone is carefully cut and then slowly pulled apart, allowing new, strong bone to grow in the gap [3][4].

Choosing the Right Device

There are two main ways to perform this lengthening, each with its own set of considerations:

Feature External Fixators (e.g., Ilizarov) Internal Motorized Nails (e.g., PRECICE)
Ideal Candidate Younger children with open growth plates or multi-directional deformities [5]. Older children, adolescents, or adults who have closed growth plates and need straight lengthening [6].
Placement A metal frame worn outside the limb, attached by pins through the skin [5]. A specialized nail implanted entirely inside the bone [7].
Pros Can correct very complex, multi-directional deformities; allows for earlier weight-bearing [8][9]. Higher patient comfort; no “pin-site” infections; no external hardware to snag on clothing [7][6].
Cons Risk of pin-site infections and muscle tethering; can be physically bulky [5][7]. Strict weight-bearing limits (often no walking) during the active lengthening phase. Contraindicated for young, growing children due to open growth plates and narrow bone canals [7][6].
Healing Requires a long duration of wear (averaging several months) [5]. Shorter hospital stays and generally faster return to activity once the bone has healed [6][10].

Recent research has shown that it is safe for surgeons to make the bone cut directly through an enchondroma (intralesional osteotomy). The bone typically heals just as well as it would if the cut were made through healthy bone [8].

Managing Pathological Fractures

Because enchondromas can thin and weaken the bone, children with Ollier disease are more prone to pathological fractures [3][11].

  • Conservative Care: Most of these fractures heal very well with standard casting or splinting and do not require surgery [3][12].
  • Surgical Care: If a fracture is severely displaced or doesn’t heal correctly, a surgeon may perform curettage and grafting [3]. This involves cleaning out the cartilage tumor and filling the space with bone graft or a bone substitute [3].
  • Important Note: Families should be aware that enchondromas have a high rate of recurrence (coming back) after they are cleaned out, especially in growing children [12][13].

The Lifelong Plan

Most orthopedic “crises,” such as fractures, tend to stop occurring once a patient reaches skeletal maturity (adulthood) [12]. However, because Ollier disease is a lifelong condition, the focus shifts in adulthood toward monitoring for any new pain or growth and managing any secondary issues like joint wear-and-tear [14][5]. Your orthopedic team will help you decide when “active” treatment like lengthening is necessary and when “observational” care is the best path forward.

Common questions in this guide

How are limb length differences treated in Ollier disease?
Limb length discrepancies are typically treated using distraction osteogenesis. This involves carefully cutting the bone and slowly pulling it apart using either an external frame or an internal motorized nail, allowing new, strong bone to grow in the gap.
What is the difference between an external fixator and an internal nail?
An external fixator is a metal frame worn outside the leg that can correct complex deformities and is safer for young, growing children. An internal motorized nail is implanted entirely inside the bone, which is more comfortable but is typically only used for older patients whose growth plates have closed.
How do doctors treat bone fractures caused by Ollier disease?
Most fractures caused by weakened bones in Ollier disease heal well with standard casting or splinting. If the fracture is severe or does not heal properly, a surgeon may need to clean out the tumor and use a bone graft to repair the area.
Will making a surgical cut through an enchondroma affect bone healing?
Recent research shows that it is safe for surgeons to make bone cuts directly through an enchondroma during lengthening procedures. The bone typically heals just as well as it would if the cut were made through healthy bone tissue.
Do enchondromas grow back after they are surgically removed?
Yes, enchondromas have a high rate of coming back after they are cleaned out using curettage and bone grafting. This recurrence is especially common in children who are still growing.

Questions to Ask Your Doctor

Curated prompts to bring to your next appointment.

  1. 1.Are my/my child's bones mature enough for an internal motorized nail, or is an external fixator a safer option for now?
  2. 2.If we choose an internal nail, what will the specific weight-bearing restrictions be during the lengthening phase?
  3. 3.Will the bone cut (osteotomy) be made directly through an enchondroma, and what does that mean for how the bone heals?
  4. 4.Given that enchondromas have a high recurrence rate, what is the plan if the tumor grows back after a curettage and grafting procedure?
  5. 5.How many limb lengthening procedures have you performed specifically on patients with Ollier disease?

Questions For You

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References

References (14)
  1. 1

    An Extremely Rare Case of Ollier Disease With Calvarial Involvement.

    Önner H, Calderon Tobar MN, Perktas L

    Clinical nuclear medicine 2025; (50(12)):1186-1187 doi:10.1097/RLU.0000000000006108.

    PMID: 40829138
  2. 2

    Severe Deforming Ollier Disease with a Giant Proximal Humeral Benign Chondroid Lesion in an Adolescent Male: Case Report.

    Prakash M, Siddhartha SA, Gurumurthy B, et al.

    Journal of orthopaedic case reports 2026; (16(7)):383-388 doi:10.13107/jocr.2026.v16.i07.7698.

    PMID: 42428399
  3. 3

    Ollier Disease: A Case Report and Review of Treatment Options.

    Kramer HD, Valentine MJ, Pettinelli N, et al.

    Cureus 2023; (15(8)):e43815 doi:10.7759/cureus.43815.

    PMID: 37731444
  4. 4

    Unhappy triad in limb reconstruction: Management by Ilizarov method.

    El-Alfy BS

    World journal of orthopedics 2017; (8(1)):42-48 doi:10.5312/wjo.v8.i1.42.

    PMID: 28144578
  5. 5

    Limb reconstruction in Ollier's disease.

    Madan SS, Robinson K, Kasliwal PD, et al.

    Strategies in trauma and limb reconstruction 2015; (10(1)):49-54 doi:10.1007/s11751-015-0223-5.

    PMID: 25861039
  6. 6

    Femoral Lengthening in Children: A Comparison of Motorized Intramedullary Nailing Versus External Fixation Techniques.

    Tillotson LO, Maddock CL, Hanley J, et al.

    Journal of pediatric orthopedics 2022; (42(5)):253-259 doi:10.1097/BPO.0000000000002120.

    PMID: 35180729
  7. 7

    PRECICE® magnetically-driven, telescopic, intramedullary lengthening nail: pre-clinical testing and first 30 patients.

    Wagner P, Burghardt RD, Green SA, et al.

    SICOT-J 2017; (3()):19 doi:10.1051/sicotj/2016048.

    PMID: 29785927
  8. 8

    How do lesions affect limb lengthening in children with Ollier's disease?

    Wu C, Huang P, Mo Y, et al.

    BMC musculoskeletal disorders 2025; (26(1)):13 doi:10.1186/s12891-024-08261-9.

    PMID: 39754076
  9. 9

    Virtual stress testing of fracture stability in soldiers with severely comminuted tibial fractures.

    Petfield JL, Hayeck GT, Kopperdahl DL, et al.

    Journal of orthopaedic research : official publication of the Orthopaedic Research Society 2017; (35(4)):805-811 doi:10.1002/jor.23335.

    PMID: 27302535
  10. 10

    Lengthening in Congenital Femoral Deficiency: A Comparison of Circular External Fixation and a Motorized Intramedullary Nail.

    Black SR, Kwon MS, Cherkashin AM, et al.

    The Journal of bone and joint surgery. American volume 2015; (97(17)):1432-40 doi:10.2106/JBJS.N.00932.

    PMID: 26333739
  11. 11

    Ollier Disease: A Case Series and Literature Review.

    Markevičiūtė V, Markevičiūtė MŠ, Stravinskas M

    Acta medica Lituanic 2021; (28(1)):181-188 doi:10.15388/Amed.2021.28.1.8.

    PMID: 34393643
  12. 12

    Multiple Enchondromas of the Hand in Children: Long-Term Follow-Up of Mean 15.4 Years.

    Kadar A, Kleinstern G, Morsy M, et al.

    Journal of pediatric orthopedics 2018; (38(10)):543-548 doi:10.1097/BPO.0000000000000869.

    PMID: 27603196
  13. 13

    Impact of Patient and Tumor Characteristics on Range of Motion and Recurrence Following Treatment of Enchondromas of the Hand.

    Wessel LE, Christ AB, Athanasian EA

    The Journal of hand surgery 2023; (48(5)):512.e1-512.e7 doi:10.1016/j.jhsa.2021.11.027.

    PMID: 35115192
  14. 14

    Multiple hereditary exostoses and enchondromatosis.

    Jurik AG

    Best practice & research. Clinical rheumatology 2020; (34(3)):101505 doi:10.1016/j.berh.2020.101505.

    PMID: 32253147

This page provides general information about orthopedic treatments for Ollier disease. Always consult with an orthopedic specialist to determine the safest and most effective surgical or medical options for your or your child's specific condition.

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