Corrective Osteotomy for Intra-Articular Malunion of the Distal Part of the Radius

Ring, David; Prommersberger, Karl-Josef; Pino, J. González del; Capomassi, Miguel; Slullitel, Miguel; Jupiter, Jesse B.

doi:10.2106/jbjs.d.02465

Cited by 62 publications

(20 citation statements)

References 17 publications

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“…In spite of different technical modifications over time, the principle of restoring the alignment of the distal radius to improve functional outcome has proven to be effective (Ring, 2005). Short-term (1-2 years) and medium-term (2-5 years) follow-up case series have reported acceptable functional outcomes (Flinkkila et al, 2000;Ladd and Huene, 1996;Oskam et al, 1996;Ring et al, 2005;Sammer et al, 2006;Thivaios and McKee, 2003;Van Cauwelaert de Wyels and De Smet, 2003;Wada et al, 2004). However, long-term results (greater than 6 years) have not yet, to our knowledge, been reported in the literature.…”

Section: Introductionmentioning

confidence: 95%

“…(Amadio and Botte, 1987;Fernandez et al, 1977;Jenkins and Mintowt-Czyz, 1988;Ring, 2005;Ring et al, 2002;Viegas, 2006) The osseous deformity can be intra-articular, extra-articular or a combination of both (Jupiter and Ring, 1996;Ring et al, 2005). The deformity, in spite of being often classified as either volar or dorsal, is in reality a three-dimensional problem that requires a three-dimensional correction for best functional outcomes (Fernandez, 1982;Jupiter and Ring, 1996).…”

Section: Introductionmentioning

confidence: 99%

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Long-Term Outcomes of Corrective Osteotomy for the Treatment of Distal Radius Malunion

Lozano-Calderón

Brouwer

Doornberg

et al. 2010

J Hand Surg Eur Vol

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Corrective osteotomy is an established but challenging treatment for distal radius malunion. Short- and intermediate-term results have been previously published while long-term results have not. The long-term results of 22 patients treated with corrective osteotomy for symptomatic distal radius malunion are presented (range 6-24 years, mean 13 years). All patients completed the DASH questionnaire and the modified Gartland and Werley, and Green and O'Brien scores postoperatively. Wrist alignment was assessed through standard wrist radiographs. Average wrist flexion-extension was 72.5% of the contralateral limb. Grip strength averaged 71%. The DASH score averaged 16 points corresponding to mild perceived disability. Results were categorized as fair on both the Gartland and Werley score (average 9 points) and the modified Green and O'Brien score (average 67 points). Wrist alignment was maintained over time but 13 patients presented mild to moderate symptomatic wrist arthritis. The outcome presented may be a reflection of the use of stricter evaluation instruments or reflect the development of post-traumatic arthritis.

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Section: Introductionmentioning

confidence: 95%

Section: Introductionmentioning

confidence: 99%

Long-Term Outcomes of Corrective Osteotomy for the Treatment of Distal Radius Malunion

Lozano-Calderón

Brouwer

Doornberg

et al. 2010

J Hand Surg Eur Vol

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“…1 The most common complication is malunion, 3,4 and symptomatic malunion in the active patient usually requires corrective osteotomy. 5,6 There is little consensus on what constitutes an 'acceptable' radiological position, which should be defined as one that will predict good function in the majority of cases. A perfect anatomical reduction is not always achievable, nor is it always necessary for a satisfactory result.…”

mentioning

confidence: 99%

What are the radiological predictors of functional outcome following fractures of the distal radius?

McQueen

2011

The Journal of Bone and Joint Surgery. British volume

132

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The fracture most commonly treated by orthopaedic surgeons is that of the distal radius. However, as yet there is no consensus on what constitutes an 'acceptable' radiological position before or after treatment. This should be defined as the position that will predict good function in the majority of cases. In this paper we review the radiological indices that can be measured in fractures of the distal radius and try to identify potential predictors of functional outcome. In patients likely to have high functional demands, we recommend that the articular reconstruction be achieved with less than 2 mm of gap or step-off, the radius be restored to within 2 mm of its normal length, and that carpal alignment be restored. The ultimate aim of treatment is a pain-free, mobile wrist joint without functional limitation.

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“…Very few articles are available on neglected intra-articular fractures or malunions. [8,[15][16][17] But all these cases had mature malunions, which presented after 6 weeks when there was solid bony consolidation, which were amenable to intra-articular osteotomy.…”

Section: Discussionmentioning

confidence: 99%

Neglected volar barton fracture treated by two-stage procedure

Jain¹,

Jain²,

Dhammi³

2017

Int J Med Sci Public Health

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Malunion following a neglected volar barton fracture can cause severe functional impairment owing to changes in normal anatomic and biomechanical relationships of the distal radius. These malunions, if mature can be treated by intra-articular osteotomies or the salvage procedures. But in nascent malunions, these procedures cannot be performed as the solid bony consolidation is absent and there is severe soft tissue contracture. In the present study, two-stage procedure was presented for the treatment of nascent neglected volar barton fracture presenting after 5 weeks, and treated primarily with gradual distraction and secondarily with open reduction and internal fixation with locked distal radius plate along with bone graft. Complete bony healing occurred in 6 months and Mayo wrist score improved from 31 to 85. At final follow-up after 2 years, visual and analog pain scores reduced from 68 to 11 and range of motion was 80° extension to 70° flexion along with near normal full grip strength along with mild wrist arthrosis. Surgical treatment of neglected fractures of distal radius can substantially improve wrist and hand functions, but rarely restores the limb to normal.

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Corrective Osteotomy for Intra-Articular Malunion of the Distal Part of the Radius

Cited by 62 publications

References 17 publications

Long-Term Outcomes of Corrective Osteotomy for the Treatment of Distal Radius Malunion

Long-Term Outcomes of Corrective Osteotomy for the Treatment of Distal Radius Malunion

What are the radiological predictors of functional outcome following fractures of the distal radius?

Neglected volar barton fracture treated by two-stage procedure

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