2005
DOI: 10.1016/j.jhsb.2004.03.016
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Staged Reconstruction for Malunited Fractures of the Distal Radius

Abstract: This prospective study assessed the outcomes of 26 symptomatic malunited distal radial fractures which were treated with an opening wedge corrective osteotomy and bone grafting with rigid fixation. An ulnar shortening osteotomy was subsequently required as a second-stage operation in five cases to restore normal ulnar variance. A wrist arthroscopy was indicated as a third stage procedure with persistent ulnar sided wrist pain in order to address central tears of the triangular fibrocartilage. Satisfactory func… Show more

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Cited by 17 publications
(13 citation statements)
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“…[9][10][11] An ulnar shortening osteotomy can be performed when there is an ulnar positive variance. 12 Various authors have noted the utility of performing an extra-articular ulnar shortening osteotomy in the treatment of both degenerative and traumatic tears of the TFCC in patients with both an ulnar positive and neutral variance. 5,6,10,[13][14][15][16][17][18][19][20] Shortening of the ulna obviously decreases the ulnar length and unloads the ulnar wrist, but it can also change the DRUJ morphology.…”
mentioning
confidence: 99%
“…[9][10][11] An ulnar shortening osteotomy can be performed when there is an ulnar positive variance. 12 Various authors have noted the utility of performing an extra-articular ulnar shortening osteotomy in the treatment of both degenerative and traumatic tears of the TFCC in patients with both an ulnar positive and neutral variance. 5,6,10,[13][14][15][16][17][18][19][20] Shortening of the ulna obviously decreases the ulnar length and unloads the ulnar wrist, but it can also change the DRUJ morphology.…”
mentioning
confidence: 99%
“…Il en va de même pour la récupération des amplitudes articulaires. Aussi bien pour la supination dont la limitation constituait une indication fréquente de correction du CVRD, que pour la flexion/extension, dont les résultats étaient comparables entre les deux groupes, et conformes à la littérature [8][9][10][11][12]. De plus, outre un logique déplacement des secteurs de mobilité dans le sens de l'ostéotomie, on constatait augmentation significative des amplitudes de 20 à 30 • C.…”
Section: Discussionunclassified
“…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
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“…If radial lengthening is complicated by soft tissue contracture, complete tenotomy or z-lengthening of the brachioradialis tendon may be helpful [63]. While callotaxis is an useful technique to achieve satisfactory length for young patients with growth arrest, combined radius-ulna osteotomy can be recommended for elderly people [43,64].…”
Section: Operative Techniquementioning
confidence: 99%