Corrective Osteotomies in Malunions of the Distal Radius
- 1 September 2006
- journal article
- section ii
- Published by Ovid Technologies (Wolters Kluwer Health) in Clinical Orthopaedics and Related Research
- Vol. 450, 179-185
- https://doi.org/10.1097/01.blo.0000223994.79894.17
Abstract
Fifteen patients with symptomatic malunions of the distal radius were treated with osteotomies, corticocancellous bone grafting, and plate and screw fixation. We investigated the ability of precise preoperative planning of the size and shape of the corticocancellous bone graft to restore alignment of the radius to within 5 degrees angular deformity and 2 mm ulnar variance as compared with the opposite uninjured wrist. Only six of 15 patients (40%) satisfied these criteria. Inter-rater reliability of radiographic assessment was greater than 0.85. Five patients had residual radial inclination or sagittal tilt greater than 10 degrees with respect to the uninvolved wrist. Four patients had a residual ulnar variance greater than 2 mm with respect to the uninvolved wrist. Residual shortening (three of four patients), but not residual angulation, was associated with unsatisfactory pain and stiffness an average of 19.5 months after osteotomy (range, 11-32 months). We conclude that a distal radius osteotomy using a precisely planned and measured interpositional corticocancellous graft does not restore distal radius alignment in most patients, and that failure to restore length is associated with continued pain and stiffness. Therapeutic study, Level IV (case series).Keywords
This publication has 22 references indexed in Scilit:
- Locking Versus Nonlocking T-Plates for Dorsal and Volar Fixation of Dorsally Comminuted Distal Radius Fractures: A Biomechanical StudyThe Journal of Hand Surgery, 2005
- Volar Fixation of Dorsally Displaced Distal Radius Fractures Using the 2.4-mm Locking Compression PlatesThe Journal of Hand Surgery, 2005
- OUTCOME AFTER CORRECTIVE OSTEOTOMY FOR MALUNITED FRACTURES OF THE DISTAL END OF THE RADIUSJournal of Hand Surgery (European Volume), 2002
- Y a-t-il une place pour le traitement conservateur de la fracture du radius distal chez l'adulte ?Chirurgie de la Main, 2001
- Reconstructive Osteotomy for Malunion of the Distal RadiusClinical Orthopaedics and Related Research, 1996
- Corrective osteotomy for malunion of the distal radiusArchives of orthopaedic and trauma surgery, 1996
- Epidemiology of Acute Wrist TraumaInternational Journal of Epidemiology, 1993
- Articular congruence of the distal radioulnar joint in case of malunited distal radiusEuropean Journal of Trauma and Emergency Surgery, 1991
- Minor axial shortening of the radius affects outcome of Colles' fracture treatmentThe Journal of Hand Surgery, 1991
- Effects of distal radius fracture malunion on wrist joint mechanicsThe Journal of Hand Surgery, 1990