Outcomes Using an Internal Osteotomy and Distraction Device for Corrective Osteotomy of Distal Radius Malunions Requiring Correction in Multiple Planes

Sammer, Douglas M.; Kawamura, Kenji; Chung, Kevin C.

doi:10.1016/j.jhsa.2006.08.009

Cited by 22 publications

(12 citation statements)

References 50 publications

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“…7,10 It has been used to evaluate subjective outcomes in multiple disorders of the upper extremity, including distal radius fractures. 6,8,9,12,24,36 The MHQ is scored on a scale from 0 to 100. The higher the score, the better the subject’s hand performance.…”

Section: Methodsmentioning

confidence: 99%

The Effect of Ulnar Styloid Fractures on Patient-Rated Outcomes After Volar Locking Plating of Distal Radius Fractures

Sammer¹,

Shah²,

Shauver³

et al. 2009

The Journal of Hand Surgery

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Purpose Ulnar styloid fractures commonly occur in association with distal radius fractures. Ulnar styloid fractures that involve the insertion of the radioulnar ligaments can result in distal radioulnar joint (DRUJ) instability, and the literature suggests that these fractures should be treated with open reduction internal fixation (ORIF). However, in the absence of DRUJ instability, the effects of ulnar styloid fractures are not known. The purpose of this study is to evaluate the outcome of ulnar styloid fractures without DRUJ instability on patient-rated outcomes after distal radius fracture ORIF. Materials and Methods Between 2003 and 2008, a prospective cohort of distal radius fracture subjects treated with volar locking plating was enrolled. Patients with DRUJ instability treated at the time of distal radius ORIF were excluded. Radiographs were evaluated to identify ulnar styloid fractures, fracture size, amount of displacement, and evidence of healing. Patient-rated outcomes were measured at 6 weeks, 3 months, 6 months, and 12 months after surgery using the Michigan Hand Outcomes Questionnaire (MHQ). Physical examination, including a specific evaluation of the DRUJ, was performed at each postoperative visit. Regression analysis was performed to determine if the presence of an ulnar styloid fracture, the size or displacement of the ulnar styloid fracture, or the healing status of the ulnar styloid fracture (union versus non-union) was predictive of MHQ scores. Results One hundred forty-four patients were enrolled; 88 patients had associated ulnar styloid fractures, and 56 did not. During the collection period, three patients with ulnar styloid fractures had DRUJ instability found intraoperatively and underwent ulnar styloid ORIF. These patients were excluded. The remaining patients with a stable DRUJ after ORIF were included in the study, and maintained DRUJ stability postoperatively. The presence of an ulnar styloid fracture was not found to be an independent predictor of MHQ scores (p=0.55). In addition, neither the size of the ulnar styloid fracture (p=0.18), nor the degree of displacement (p=0.25) was found to be a significant independent predictor of MHQ scores. Furthermore, the healing status of the fracture (union versus non-union) was not predictive of MHQ scores (p=0.95). Conclusion In patients with a stable DRUJ after distal radius ORIF with a volar locking plate, the presence of an ulnar styloid fracture did not affect subjective outcomes as measured by the MHQ. Furthermore, neither the size of the ulnar styloid fracture, the degree of displacement, nor the presence or absence of radiographic union affected subjective outcomes as measured by the MHQ.

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Section: Methodsmentioning

confidence: 99%

The Effect of Ulnar Styloid Fractures on Patient-Rated Outcomes After Volar Locking Plating of Distal Radius Fractures

Sammer¹,

Shah²,

Shauver³

et al. 2009

The Journal of Hand Surgery

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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%

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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“…On note aussi que les faibles raccourcissements autorisant un traitement conservateur sont essentiellement rencontrés dans les CV à déplacement postérieur les formes antérieures étant de moins bon pronostic. Les travaux portant sur la correction de CV extra-articulaires du radius [9][10][11][12]14,[16][17][18][19][20][21][22], montrent que tous les auteurs n'ayant pas eu recours à un geste sur la RUD avaient dans leurs séries des variances ulnaires inférieures à 5 mm, à l'inverse ceux associant un geste palliatif sur la RUD ou un raccourcissement de l'ulna rapportaient des variances supérieures à 5 mm [8,23]. D'ailleurs dans ces mêmes séries, malgré une réorienta-tion de l'épiphyse radiale satisfaisante, on constate une correction de la variance ulnaire par l'ostéotomie radiale de seulement quelques millimètre.…”

Section: Discussionunclassified

La résection de l’ulna distal influence-t-elle les résultats de la correction par ostéotomie des cals vicieux de l’extrémité inférieure du radius ?

Coulet

Ouali

Boretto

et al. 2011

Revue de Chirurgie Orthopédique et Traumatologique

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Outcomes Using an Internal Osteotomy and Distraction Device for Corrective Osteotomy of Distal Radius Malunions Requiring Correction in Multiple Planes

Cited by 22 publications

References 50 publications

The Effect of Ulnar Styloid Fractures on Patient-Rated Outcomes After Volar Locking Plating of Distal Radius Fractures

The Effect of Ulnar Styloid Fractures on Patient-Rated Outcomes After Volar Locking Plating of Distal Radius Fractures

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

La résection de l’ulna distal influence-t-elle les résultats de la correction par ostéotomie des cals vicieux de l’extrémité inférieure du radius ?

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