Scientific articleCorrective Osteotomy for Combined Intra- and Extra-articular Distal Radius Malunion
Section snippets
Patients
Between 1998 and 2009, we treated 21 consecutive adult patients for combined intra- and extra-articular distal radius malunions at 1 of 4 institutions. All patients were invited to return for assessment of the wrist after a minimum of 2 years after osteotomy. Two patients had died of unrelated causes, 1 patient did not have 2 years of follow-up, and 18 patients returned. Prior data of 6 of the 18 patients were reported previously as part of a clinical outcome study of intra-articular distal
Results
The mean duration of follow-up was 78 months (median, 88 months; range, 24–134 months). The osteotomy healed uneventfully in all 18 patients (Fig. 5). All measurements of final range of motion and grip strength compared with preoperative measures and to the contralateral arm significantly (P < .05) improved as a result of the corrective osteotomy (Table 1). All patients expressed high satisfaction with the final outcome, even the patient who scored a poor outcome on the MMWS because of limited
Discussion
The present study showed that a corrective osteotomy for combined intra- and extra-articular distal radius malunion can effectively improve wrist function with reproducible results and a high subjective satisfaction rate. Similar to previous series, failure of the procedure (considered as osteonecrosis at the osteotomy site or early partial radioscapholunate or total wrist arthrodesis) did not occur; these failures are considered rare complications.2, 4, 5, 9 Hardware removal occurred at a high
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Cited by (29)
Managing the Intra-articular Distal Radius Malunion
2024, Hand ClinicsTreatment of the Intraarticular Malunited Distal Radius
2021, Distal Radius Fractures: Evidence-Based ManagementInstability in the Setting of Distal Radius Fractures: Diagnosis, Evaluation, and Treatment
2020, Hand ClinicsCitation Excerpt :The surgeon must also consider a patient’s pain, activity level, and functional limitations before proceeding. Distal radius osteotomy is a reliable treatment option for a young, physically active patient with an incongruent and unstable DRUJ.49,50 Malunion with volar angulation greater than 15°, dorsal angulation greater than 10°, or radial shortening greater than 3 mm all are indications for osteotomy (Fig. 5).49
Computer-assisted 3D preoperative planning of corrective osteotomy for extra-articular distal radius malunion: A 16-patient case series
2020, Hand Surgery and RehabilitationCitation Excerpt :With these techniques, 3D virtual bone models can be created of both the deformed and contralateral unaffected radii. These models are then used to plan the bone correction and the radius osteotomy preoperatively [7]. Recent studies have confirmed the possibility of creating 3D bone models from CT scan data.
Intra-articular corrective osteotomy for intra-articular malunion of distal radius fracture using three-dimensional surgical computer simulation and patient-matched instrument
2020, Journal of Orthopaedic ScienceCitation Excerpt :For intra-articular malunion, a salvage procedure, such as partial wrist arthrodesis, is sometimes indicated to reduce wrist pain, although it may lead to loss of motion as corrective osteotomy is technically difficult to perform [8–10]. Several investigators have reported favorable results from intra-articular corrective osteotomy for symptomatic intra-articular malunion with or without arthroscopic assistance [9,11–14]. However, dissection of the joint capsule and ligament to perform osteotomy with direct view of the articular surface may result in postoperative joint stiffness.
Rates of Corrective Osteotomy After Distal Radius Fractures Treated Nonsurgically and Surgically
2019, Journal of Hand Surgery Global Online
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