Ulnar shortening osteotomy as a treatment of symptomatic ulnar impaction syndrome after malunited distal radius fractures

A wide range of different classifications exist for distal radius fractures (DRF). Most of them are based on plane X-rays and do not give us any information on how to treat these fractures. A biomechanical understanding of the mechanical forces underlying each fracture type is important to treat each injury specifically and ensure the optimal choice for stabilization. The main cause of DRFs are forces acting on the carpus and the radius as well as the position of the wrist in relation to the radius. Reconstructing the mechanism of the injury gives insight into which structures are involved, such as ruptured ligaments, bone fragments as well as the dislocated osteoligamentous units. This article attempts to define certain key fragments, which seem crucial to reduce and stabilize each type of DRF. Once the definition is established, an ideal implant can be selected to sufficiently maintain reduction of these key fragments. Additionally, the perfect approach is selected. By applying the following principles, the surgeon may be assisted in choosing the ideal form of treatment approach and implant selection.

Section: Introductionmentioning

confidence: 99%

Biomechanical considerations on a CT-based treatment-oriented classification in radius fractures

Hintringer¹,

Rosenauer

Pezzei

et al. 2020

“…Indications and techniques of corrective osteotomy and ulnar shortening osteotomie after malunited DRF are discussed by Krimmer et al [65] and Terzis et al [66].…”

Section: Treatment Options Of Symptomatic Malunited Distal Radius Fracturesmentioning

confidence: 99%

Salvage procedure after malunited distal radius fractures and management of pain and stiffness

Keuchel-Strobl

Quadlbauer

Jurkowitsch

et al. 2020

Indications for surgical treatment of distal radius fractures (DRF) remain controversial in the literature, especially in elderly patients. Complication rates after operatively treated DRF are low and well documented. These include malunion, degenerative osteoarthritis in the radiocarpal joint and subsequently pain and impaired hand function. If conservative treatment fails then salvage procedures are necessary. This review summarizes the therapeutic options available to treat degenerative osteoarthritis after malunited distal radius fractures, regardless of the initial operative or conservative treatment.

“…This method has become a reliable and standard procedure using fixed-angle ulnar shortening plates. The article by Terzis et al [15] "Ulnar shortening osteotomy as a treatment of symptomatic ulnar impaction syndrome after malunited distal radius fractures" describes this procedure in detail.…”

Section: Extraarticular Malalignmentmentioning

confidence: 99%

Corrective osteotomy after malunited distal radius fractures

Krimmer¹,

Schandl

Wolters

2020

Posttraumatic malunion or secondary dislocation can cause wrist joint incongruency. Uncorrected malalignment increases the risk of secondary degenerative changes and chronic pain. Therefore, early correction using the available fixed-angle devices, cancellous bone grafting only becomes necessary in larger bony defects. Premounting the plate through a palmar approach with regard to the desired correction angles leads to predictable results by precise correction. In case of posttraumatic growth arrest with larger discrepancy of the radius and the ulna, a two-staged procedure is advisable.