Gradual Reduction of Distal Radial Malunion Using Distraction Osteogenesis

Lubahn, John D.; Hood, John; Nechleba, Jeffrey; Williams, D. Patrick; Green, Ted

doi:10.1016/j.jhsa.2007.04.009

Cited by 12 publications

(5 citation statements)

References 20 publications

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“…Previous studies have reported forearm lengthening in patients with malformation pathologies such as radial dysplasia and multiple exostoses, and thus in these studies a normal distal radioulnar joint relationship could not be reliably restored (Akita et al, 2007;Launay et al, 2004;Matsuno et al, 2006). A number of authors have reported satisfactory results after gradual correction of distal radial malunion or premature epiphyseal closure using distraction osteogenesis, but did not adequately address the status of the distal radioulnar joint (Houshian et al, 2004;Justan et al, 2004;Lubahn et al, 2007). Distal radioulnar joint instability and ulnocarpal impingement as a result of radial shortening, angulation and/or malrotation of the distal radius can usually be corrected by radial osteotomy alone (Fernandez, 1982).…”

Section: Discussionmentioning

confidence: 99%

“…The surgical procedures utilised were similar to those described previously (Houshian et al, 2004; Lubahn et al, 2007). A single-rod external fixator was used in three patients and a half-ring external fixator was used in three.…”

Section: Methodsmentioning

confidence: 99%

“…As an alternative to acute correction, gradual lengthening has been used for congenital shortening in children (Abe et al, 1996; Launay et al, 2004), for radial longitudinal instability after radial head excision (Capuano et al, 2001) and for distal radius malunion (Lubahn et al, 2007). Although the results of gradual lengthening are satisfactory in terms of restoring bony parameters such as radial length, inclination and palmar tilt, congruent reduction of the distal radioulnar joint has not been specifically assessed in the previous studies.…”

Section: Introductionmentioning

confidence: 99%

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Computed Tomographic Assessment of Reduction of the Distal Radioulnar Joint by Gradual Lengthening of the Radius

Gong

Roh

et al. 2009

J Hand Surg Eur Vol

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Congruency of the distal radioulnar joint was assessed by computed tomography after gradual lengthening of the radius in patients with considerable ulnar positive variance of mean 12 (range 10-17) mm and chronic dislocation of the distal radioulnar joint. Six patients of mean age 25 years were treated by radial osteotomy and subsequent gradual lengthening using either a single-rod or a half-ring external fixator, which was applied for a mean of 81 days. The causes of deformity were distal radial epiphyseal injury in four, malunion of a radius shaft fracture in one and Madelung deformity in one. Computed tomography scans taken at 1 year postoperatively demonstrated that all patients had a congruent distal radioulnar joint. All patients achieved symptom and radiographic parameter improvements at a mean follow-up of 40 months. A disadvantage was unattractive scars on a cosmetically important surface of the forearm. Given a relatively intact bony contour of the distal radioulnar joint, congruent reduction of the distal radioulnar joint can be obtained by gradual lengthening of the radius.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Computed Tomographic Assessment of Reduction of the Distal Radioulnar Joint by Gradual Lengthening of the Radius

Gong

Roh

et al. 2009

J Hand Surg Eur Vol

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“…Radial length discrepancies due to exostosis, trauma to the epiphyseal plate or congenital deficiencies will result in functional and cosmetic problems [1, 2]. Radial length discrepancies not only result in limb shortening but are also accompanied by wrist dysfunction and dislocation of the inferior radioulnar joint [3, 4].…”

Section: Introductionmentioning

confidence: 99%

Bifocal osteosynthesis to treat radial shortening deformity with dislocation of the inferior radioulnar joint

Guan

Ruan

Yin

et al. 2019

BMC Musculoskelet Disord

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Background Several methods have been reported to correct deformity and shortening of the distal radius. However, the results are not entirely satisfactory. The results of bifocal osteosynthesis were retrospectively analyzed in this study. Methods Eight patients treated with bifocal osteosynthesis were evaluated retrospectively. Pre-operative and post-operative clinical and radiographic examinations were performed. Subjective symptoms and objective joint function were assessed. Radiographic data of the extent of radial lengthening and distal radial articular angle were collected. Results The mean follow-up period was 46 months (37–68 months). Satisfactory wrist appearance and radial lengthening was achieved in all patients. All patients were satisfied with the wrist appearance and willing to undergo the same treatment again. The range of motion (ROM) of the forearm and wrist was significantly improved. Pin-track infections occurred in two patients, for which they received wound care and oral antibiotics. Complications such as fixation device failure, tendon rupture, fracture of regenerated bone or nerve impairment did not occur. The duration of lengthening depended on the shortening of the radius. Delayed union in the docking site was observed in two patients and union was achieved after bone grafting. Conclusions Bifocal osteosynthesis using the Ilizarov method provides a useful method for correction of radial shortening deformity with dislocation of the inferior radioulnar joint. Despite the fact that we did not validate pre-and post-operation functional outcome scores, all patients were satisfied with the wrist appearance and function.

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“…Corrective osteotomy of the distal part of the radius can be used to treat extra-articular malunion. Because of the complexity of the deformity, the various types of malunion, and the inherent technical challenges of surgical correction, numerous techniques have been described [3][4][5][6][7][8][9][10][11][12][13] , including opening-wedge osteotomy 3 . Fernandez 3 used iliac crest bone graft to allow simultaneous correction of angular and shortening deformities of the distal part of the radius without an ulnar osteotomy.…”

Section: Introductionmentioning

confidence: 99%