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International Orthopaedics

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12.05.2018 | Original Paper

A comparison of corrective osteotomies using dorsal and volar fixation for malunited distal radius fractures

verfasst von: Kunihiro Oka, Toshiyuki Kataoka, Hiroyuki Tanaka, Kiyoshi Okada, Hideki Yoshikawa, Tsuyoshi Murase

Erschienen in: International Orthopaedics | Ausgabe 12/2018

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Abstract

Purpose

This study aimed to compare clinical results and to restore radiographic parameters of corrective osteotomy for malunited distal radius fracture using a volar locking plate with a dorsal plate.

Methods

We retrospectively studied 28 consecutive patients with symptomatic malunited distal radius fractures followed up for more than 12 months who underwent corrective osteotomy with a dorsal buttress plate (n = 9) or a volar locking plate (n = 19). Volar tilt (VT), radial inclination (RI), and ulnar variance (UV) were radiographically evaluated. Clinical examination parameters included pain, wrist and forearm ranges of motion (ROM), grip strength, and Mayo Modified Wrist Score (MMWS).

Results

The volar group had a significantly greater VT undercorrection for − 9.4° than did the dorsal group for − 1.2° (p < 0.001). Major complications requiring plate removal occurred in six of nine patients in the dorsal group and two of 19 patients in the volar group. The complication ratio was significantly greater in the dorsal group than in the volar group (p < 0.05). Improvements in forearm and wrist ROM, grip strength, and MMWS did not differ significantly between groups.

Conclusions

Opening wedge osteotomy of the radius using a volar locking plate is preferable to dorsal buttress fixation in terms of surgical and technical demands and frequency of complications, but VT correction is insufficient. Surgeons should be aware of the mismatch between the plate and the volar surface of the malunited distal radius.

Cooney WP 3rd, Dobyns JH, Linscheid RL (1980) Complications of Colles’ fractures. The Journal of bone and joint surgery American 62(4):613–619CrossRef

Fernandez DL (1982) Correction of post-traumatic wrist deformity in adults by osteotomy, bone-grafting, and internal fixation. The Journal of bone and joint surgery American 64(8):1164–1178CrossRef

Jupiter JB, Fernandez DL (2002) Complications following distal radial fractures. Instr Course Lect 51:203–219PubMed

Ladd AL, Huene DS (1996) Reconstructive osteotomy for malunion of the distal radius. Clin Orthop Relat Res 327:158–171CrossRef

Prommersberger KJ, Van Schoonhoven J, Lanz UB (2002) Outcome after corrective osteotomy for malunited fractures of the distal end of the radius. J Hand Surg Br 27(1):55–60. https://doi.org/10.1054/jhsb.2001.0693 CrossRefPubMed

Athwal GS, Ellis RE, Small CF, Pichora DR (2003) Computer-assisted distal radius osteotomy. J Hand Surg Am 28(6):951–958CrossRefPubMed

Miyake J, Murase T, Moritomo H, Sugamoto K, Yoshikawa H (2011) Distal radius osteotomy with volar locking plates based on computer simulation. Clin Orthop Relat Res 469(6):1766–1773. https://doi.org/10.1007/s11999-010-1748-z CrossRefPubMedPubMedCentral

Murase T, Oka K, Moritomo H, Goto A, Yoshikawa H, Sugamoto K (2008) Three-dimensional corrective osteotomy of malunited fractures of the upper extremity with use of a computer simulation system. J Bone Joint Surg Am 90(11):2375–2389. https://doi.org/10.2106/JBJS.G.01299 CrossRefPubMed

Fernandez DL (1988) Radial osteotomy and bowers arthroplasty for malunited fractures of the distal end of the radius. The Journal of bone and joint surgery American 70(10):1538–1551CrossRef

10.

Jupiter JB, Ring D (1996) A comparison of early and late reconstruction of malunited fractures of the distal end of the radius. The Journal of bone and joint surgery American 78(5):739–748CrossRef

11.

Malone KJ, Magnell TD, Freeman DC, Boyer MI, Placzek JD (2006) Surgical correction of dorsally angulated distal radius malunions with fixed angle volar plating: a case series. J Hand Surg Am 31(3):366–372. https://doi.org/10.1016/j.jhsa.2005.10.017 CrossRefPubMed

12.

Oka K, Murase T, Moritomo H, Goto A, Sugamoto K, Yoshikawa H (2010) Corrective osteotomy using customized hydroxyapatite implants prepared by preoperative computer simulation. The international journal of medical robotics + computer assisted surgery: MRCAS 6(2):186–193. https://doi.org/10.1002/rcs.305 CrossRefPubMed

13.

Osada D, Kamei S, Takai M, Tomizawa K, Tamai K (2007) Malunited fractures of the distal radius treated with corrective osteotomy using volar locking plate and a corticocancellous bone graft following immediate mobilisation. Hand Surg 12(3):183–190. https://doi.org/10.1142/S0218810407003560 CrossRefPubMed

14.

Wijffels MM, Orbay JL, Indriago I, Ring D (2012) The extended flexor carpi radialis approach for partially healed malaligned fractures of the distal radius. Injury 43(7):1204–1208. https://doi.org/10.1016/j.injury.2012.04.002 CrossRefPubMed

15.

Murase T (2016) Surgical technique of corrective osteotomy for malunited distal radius fracture using the computer-simulated patient matched instrument. J Hand Surg Asian Pac Vol 21(2):133–139. https://doi.org/10.1142/S2424835516400051 CrossRefPubMed

16.

Murase T, Oka K, Moritomo H, Goto A, Sugamoto K, Yoshikawa H (2009) Correction of severe wrist deformity following physeal arrest of the distal radius with the aid of a three-dimensional computer simulation. Arch Orthop Trauma Surg 129(11):1465–1471. https://doi.org/10.1007/s00402-008-0800-x CrossRefPubMed

17.

Oka K, Moritomo H, Goto A, Sugamoto K, Yoshikawa H, Murase T (2008) Corrective osteotomy for malunited intra-articular fracture of the distal radius using a custom-made surgical guide based on three-dimensional computer simulation: case report. J Hand Surg Am 33(6):835–840. https://doi.org/10.1016/j.jhsa.2008.02.008 CrossRefPubMed

18.

Oka K, Murase T, Moritomo H, Goto A, Sugamoto K, Yoshikawa H (2009) Accuracy analysis of three-dimensional bone surface models of the forearm constructed from multidetector computed tomography data. The international journal of medical robotics + computer assisted surgery : MRCAS 5(4):452–457. https://doi.org/10.1002/rcs.277 CrossRefPubMed

19.

Oka K, Murase T, Moritomo H, Goto A, Nakao R, Sugamoto K, Yoshikawa H (2011) Accuracy of corrective osteotomy using a custom-designed device based on a novel computer simulation system. Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association 16(1):85–92. https://doi.org/10.1007/s00776-010-0020-4 CrossRef

20.

Omori S, Murase T, Kataoka T, Kawanishi Y, Oura K, Miyake J, Tanaka H, Yoshikawa H (2014) Three-dimensional corrective osteotomy using a patient-specific osteotomy guide and bone plate based on a computer simulation system: accuracy analysis in a cadaver study. The international journal of medical robotics + computer assisted surgery: MRCAS 10(2):196–202. https://doi.org/10.1002/rcs.1530 CrossRefPubMed

21.

Williamson SC, Feldon P (1995) Extensor tendon ruptures in rheumatoid arthritis. Hand Clin 11(3):449–459PubMed

22.

Cooney WP, Bussey R, Dobyns JH, Linscheid RL (1987) Difficult wrist fractures. Perilunate fracture-dislocations of the wrist. Clin Orthop Relat Res 214:136–147

23.

Martinez-Mendez D, Lizaur-Utrilla A, de Juan-Herrero J (2018) Prospective study of comminuted articular distal radius fractures stabilized by volar plating in the elderly. Int Orthop. https://doi.org/10.1007/s00264-018-3903-1

24.

Srinivasan RC, Jain D, Richard MJ, Leversedge FJ, Mithani SK, Ruch DS (2013) Isolated ulnar shortening osteotomy for the treatment of extra-articular distal radius malunion. The Journal of Hand Surgery 38(6):1106–1110. https://doi.org/10.1016/j.jhsa.2013.03.015

25.

von Campe A, Nagy L, Arbab D, Dumont CE (2006) Corrective osteotomies in malunions of the distal radius: do we get what we planned? Clin Orthop Relat Res 450:179–185. https://doi.org/10.1097/01.blo.0000223994.79894.17 CrossRef

26.

Kiyoshige Y (2002) Condylar stabilizing technique with AO/ASIF distal radius plate for Colles’ fracture associated with osteoporosis. Tech Hand Up Extrem Surg 6(4):205–208CrossRefPubMed

27.

Babikir EME, Al-Maqdassy ED, Hasan K, Abdul Hameed S, Alhammoud A, Al-Dosari MMA (2017) Efficiency of fragment specific fixation plates in the treatment of comminuted distal radial fractures. Int Orthop 41(9):1763–1769. https://doi.org/10.1007/s00264-017-3516-0 CrossRefPubMed

Titel: A comparison of corrective osteotomies using dorsal and volar fixation for malunited distal radius fractures
verfasst von: Kunihiro Oka
Toshiyuki Kataoka
Hiroyuki Tanaka
Kiyoshi Okada
Hideki Yoshikawa
Tsuyoshi Murase
Publikationsdatum: 12.05.2018
Verlag: Springer Berlin Heidelberg
Erschienen in: International Orthopaedics / Ausgabe 12/2018
Print ISSN: 0341-2695
Elektronische ISSN: 1432-5195
DOI: https://doi.org/10.1007/s00264-018-3972-1

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A comparison of corrective osteotomies using dorsal and volar fixation for malunited distal radius fractures

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Results

Conclusions

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Springer Medizin

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Methods

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