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Osteotomy of dorsally displaced malunited fractures of the distal radius: no loss of radiographic correction during healing with a minimally invasive fixation technique and an injectable bone substitute.

Abramo, Antonio LU ; Tägil, Magnus LU ; Geijer, Mats and Kopylov, Philippe LU (2008) In Acta Orthopaedica 79(2). p.262-268
Abstract
BACKGROUND AND PURPOSE: Malunion after a distal radius fracture can be treated with an osteotomy of the distal radius. Often autologous iliac crest bone graft is used to fill the gap, but this is associated with donor site morbidity. Instead of bone graft, we have used a slow-resorbing bone substitute in combination with a minimally invasive fixation technique. PATIENTS AND METHODS: 25 consecutive patients with a dorsal malunion after a distal radius fracture underwent an osteotomy. A TriMed buttress pin and a radial pin plate were used for fixation, and Norian SRS as bone substitute. The patients were followed for a minimum of 1 year and range of motion, grip strength, DASH scores, and the radiographic correction were measured. RESULTS:... (More)
BACKGROUND AND PURPOSE: Malunion after a distal radius fracture can be treated with an osteotomy of the distal radius. Often autologous iliac crest bone graft is used to fill the gap, but this is associated with donor site morbidity. Instead of bone graft, we have used a slow-resorbing bone substitute in combination with a minimally invasive fixation technique. PATIENTS AND METHODS: 25 consecutive patients with a dorsal malunion after a distal radius fracture underwent an osteotomy. A TriMed buttress pin and a radial pin plate were used for fixation, and Norian SRS as bone substitute. The patients were followed for a minimum of 1 year and range of motion, grip strength, DASH scores, and the radiographic correction were measured. RESULTS: Forearm rotation improved from 137 degrees to 155 degrees , flexion/extension from 102 degrees to 120 degrees , and radioul-nar deviation from 32 degrees to 43 degrees . Grip strength increased from 62% of the contralateral hand to 82%. DASH scores decreased from 36 to 23. Radiographically, all osteotomies but 1 healed and the radiographic correction achieved was consistent over the first year. INTERPRETATION: Osteotomy of the distal radius is effective in increasing motion and grip strength after a malunited distal radial fracture. Patient satisfaction is high and subjective results measured with DASH are good. Using a bone substitute, the operation can be performed as an outpatient procedure and donor-site pain avoided. No loss of the radiographic correction achieved was noted during osteotomy healing. (Less)
Please use this url to cite or link to this publication:
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organization
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type
Contribution to journal
publication status
published
subject
keywords
Fractures, Radius Fractures: radiography, Calcium Phosphates: administration & dosage, Surgical Procedures, Osteotomy: methods, Radius Fractures: surgery, Internal: methods, Minimally Invasive: methods, Malunited: surgery, Fracture Fixation, Radius Fractures: physiopathology, Bone Substitutes: administration & dosage
in
Acta Orthopaedica
volume
79
issue
2
pages
262 - 268
publisher
Taylor & Francis
external identifiers
  • wos:000256188900016
  • pmid:18484254
  • scopus:44249085658
ISSN
1745-3682
DOI
10.1080/17453670710015085
language
English
LU publication?
yes
id
4d7b6bbe-dfa4-4133-95c9-eca7f157d999 (old id 1154073)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/18484254?dopt=Abstract
date added to LUP
2008-06-05 09:10:31
date last changed
2017-07-09 04:00:25
@article{4d7b6bbe-dfa4-4133-95c9-eca7f157d999,
  abstract     = {BACKGROUND AND PURPOSE: Malunion after a distal radius fracture can be treated with an osteotomy of the distal radius. Often autologous iliac crest bone graft is used to fill the gap, but this is associated with donor site morbidity. Instead of bone graft, we have used a slow-resorbing bone substitute in combination with a minimally invasive fixation technique. PATIENTS AND METHODS: 25 consecutive patients with a dorsal malunion after a distal radius fracture underwent an osteotomy. A TriMed buttress pin and a radial pin plate were used for fixation, and Norian SRS as bone substitute. The patients were followed for a minimum of 1 year and range of motion, grip strength, DASH scores, and the radiographic correction were measured. RESULTS: Forearm rotation improved from 137 degrees to 155 degrees , flexion/extension from 102 degrees to 120 degrees , and radioul-nar deviation from 32 degrees to 43 degrees . Grip strength increased from 62% of the contralateral hand to 82%. DASH scores decreased from 36 to 23. Radiographically, all osteotomies but 1 healed and the radiographic correction achieved was consistent over the first year. INTERPRETATION: Osteotomy of the distal radius is effective in increasing motion and grip strength after a malunited distal radial fracture. Patient satisfaction is high and subjective results measured with DASH are good. Using a bone substitute, the operation can be performed as an outpatient procedure and donor-site pain avoided. No loss of the radiographic correction achieved was noted during osteotomy healing.},
  author       = {Abramo, Antonio and Tägil, Magnus and Geijer, Mats and Kopylov, Philippe},
  issn         = {1745-3682},
  keyword      = {Fractures,Radius Fractures: radiography,Calcium Phosphates: administration & dosage,Surgical Procedures,Osteotomy: methods,Radius Fractures: surgery,Internal: methods,Minimally Invasive: methods,Malunited: surgery,Fracture Fixation,Radius Fractures: physiopathology,Bone Substitutes: administration & dosage},
  language     = {eng},
  number       = {2},
  pages        = {262--268},
  publisher    = {Taylor & Francis},
  series       = {Acta Orthopaedica},
  title        = {Osteotomy of dorsally displaced malunited fractures of the distal radius: no loss of radiographic correction during healing with a minimally invasive fixation technique and an injectable bone substitute.},
  url          = {http://dx.doi.org/10.1080/17453670710015085},
  volume       = {79},
  year         = {2008},
}