Corrective osteotomy of the distal radius after fracture to restore the function of wrist joint, forearm, and hand

Roesgen, M.; Hierholzer, G.

doi:10.1007/bf00451511

Cited by 19 publications

(6 citation statements)

References 7 publications

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“…The average postsurgical grip strength as a percentage of the opposite side was 73%, which was slightly less than that reported after opening wedge osteotomy. 1,4,9,28 It None was comparable, however, to that reported after the combination of opening wedge radial osteotomy and Bowers arthroplasty. 3 All of our patients were satisfied with improved grip strength and none of them complained of wrist weakness in ordinary daily living.…”

Section: Discussionsupporting

confidence: 73%

“…[1][2][3][4][5][6][7][8][9][10] By using iliac bone graft it provides the opportunity for simultaneous correction of distal radioulnar and ulnocarpal malalignment and function without separate surgery for the distal ulna. The surgical procedure has been indicated rarely for patients with osteopenia because of the risk of failure of fixation followed by recurrent malunion.…”

mentioning

confidence: 99%

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Simultaneous radial closing wedge and ulnar shortening osteotomies for distal radius malunion

Wada

Isogai

Kanaya

et al. 2004

The Journal of Hand Surgery

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Section: Discussionsupporting

confidence: 73%

mentioning

confidence: 99%

Simultaneous radial closing wedge and ulnar shortening osteotomies for distal radius malunion

Wada

Isogai

Kanaya

et al. 2004

The Journal of Hand Surgery

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“…The average postoperative grip strength, as a percentage of the opposite side was 73%, 21 which was slightly less than that reported after opening wedge osteotomy. 1,4,9,22 However, it was comparable to that reported after the combination of opening wedge radial osteotomy and Bowers arthroplasty. 3 All of our patients were satisfied with improved grip strength and none of them complained of wrist weakness in ordinary daily living.…”

Section: N Malunited Smith's Fracturesupporting

confidence: 85%

“…[1][2][3][4][5][6][7][8][9][10] By using iliac bone graft, it provides the opportunity for simultaneous correction of distal radioulnar and ulnocarpal malalignment and function without separate operation for the distal ulna. The operative procedure has been rarely indicated for patients with osteopenia because of the risk of failure of fixation followed by recurrent malunion.…”

Section: N Historical Perspectivementioning

confidence: 99%

Simultaneous Radial Closing Wedge and Ulnar Shortening Osteotomy for Distal Radius Malunion

Wada

Tsuji

Iba

et al. 2005

Techniques in Hand &Amp; Upper Extremity Surgery

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Closing wedge osteotomies are an attractive treatment option for distal radius malunion in patients with osteopenia. It does not require a separate-site bone graft, result-ing in decreased morbidity. However, this procedure has always been performed in combination with ulnar head resection to accommodate closure of corrective osteotomy and to address the issue of ulnocarpal abutment. Because ulnar shortening osteotomy is more physiological solution, it seemed advantageous to us to combine radial closing wedge osteotomy and ulnar shortening osteotomy. In this article, we present in detail our technique for treating patients with distal radius malunion. The patients are potentially osteopenic such as women aged over 45 years and are active at home, work, and/or recreation but are not involved in heavy physical work. Through volar approach an appropriate bone wedge is removed from the distal radius. A small volar T-plate is used to secure the osteotomized bone fragments. The aim of the radial osteotomy is to correct the dorsal angulation in the sagittal plane within a normal range of 1 degree to 2 degrees with reference to that of opposite wrist. Ulnar shortening osteotomy is performed by using transverse osteotomy and compression plating technique with an AO compression device. The ulnar variance is adjusted to neutral. Although the technique presented requires the surgeons to use careful plate and screw technique, early results have been encouraging, and patients with osteopenia can be treated successfully. Decreased grip strength which may be provoked by shorting of the forearm is acceptable.

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“…Therefore various techniques have been described. [13][14][15][16][17] The standard treatment method 10,13,18 is based on using an appropriately sized and shaped iliac crest autologous bone graft, which is inserted from dorsal into the osteotomy gap and which, by virtue of its shape, leads to the correction of the malunion. The resulting position is subsequently stabilized with wires, screws, or a plate.…”

mentioning

confidence: 99%

Opening Wedge Osteotomy for Distal Radius Malunion: Dorsal or Palmar Approach?

2013

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Background?There are various technical variations to consider when performing a corrective osteotomy of a distal radius malunion. We chose two of the more commonly reported techniques and compared the results of volar (palmar) osteotomy and fixation with dorsal osteotomy and fixation. Method?Within a continuous cohort of patients who had undergone corrective osteotomy for a malunited Colles fracture, two groups could be identified retrospectively. In 8 patients a dorsal approach was used. A structural trapezoidal graft, subtending the amount of correction, was inserted into the osteotomy gap and stabilization was performed with a thin round-hole mini-fragment plate. In 14 patients a palmar approach and a palmar fixed-angle plate was used for correction of the malunion and for angular stable rigid fixation of the two fragments. The osteotomy gap was loosely filled with nonstructural cancellous bone chips. A retrospective comparison of the two groups was performed to see whether the outcome was affected by the use of either operative technique.The demographics, the preoperative amount of deformity, range of motion, pain, and force were comparable for both groups. All osteotomies healed without loss of correction. After a minimal follow-up of one year, radiographic appearance, objective functional parameters were assessed and subjective data (Disabilities of the Arm, Shoulder, and Hand [DASH] score and special pain and function questionnaire) obtained. Results?These data did not show statistical difference for the two groups except for the amount of final wrist flexion. This parameter was significantly better in patients who had palmar approaches and fixed-angle plates. Conclusion?Corrective osteotomies of distal radius malunions can be done in either way. It might result in some better flexion, if performed volarly.

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Corrective osteotomy of the distal radius after fracture to restore the function of wrist joint, forearm, and hand

Cited by 19 publications

References 7 publications

Simultaneous radial closing wedge and ulnar shortening osteotomies for distal radius malunion

Simultaneous radial closing wedge and ulnar shortening osteotomies for distal radius malunion

Simultaneous Radial Closing Wedge and Ulnar Shortening Osteotomy for Distal Radius Malunion

Opening Wedge Osteotomy for Distal Radius Malunion: Dorsal or Palmar Approach?

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