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[Distal radius malunions in flexion].

P Saffar1, Y Tafnkji

  • 1Institut français de chirurgie de la main, 5, rue du Dôme, 75116 Paris, France. psaffar@ifcm.org

Chirurgie De La Main
|January 10, 2006
PubMed
Summary

Distal radius malunion in flexion can be treated with combined radius and ulna osteotomy for younger patients, restoring normal anatomy and function. Isolated procedures may suffice in specific cases, with combined surgery offering the best outcomes.

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Area of Science:

  • Orthopedic surgery
  • Biomechanics of the upper limb

Context:

  • Distal radius malunion in flexion is a rare but significant complication.
  • Iatrogenic causes, such as poorly performed posterior intrafocal pinning, are increasingly prevalent.
  • Malunion in flexion typically presents with decreased range of motion, particularly in pronation-supination, and minimal radial shortening.

Purpose:

  • To differentiate the clinical management of distal radius malunion in extension versus flexion.
  • To compare the outcomes of three surgical techniques for distal radius malunion in flexion: isolated radius osteotomy, isolated ulna procedure, and combined radius and ulna osteotomy.
  • To identify optimal treatment strategies based on patient age and deformity characteristics.

Summary:

  • A retrospective study of 20 young patients (mean age 39.3) with distal radius malunion in flexion was conducted.
  • Surgical outcomes were compared across isolated radius osteotomy, isolated ulna procedure, and combined radius and ulna osteotomy groups.
  • All three techniques yielded similar improvements in pronation-supination range of motion, with significant reductions in pain and increased grip strength.

Impact:

  • Combined radius and ulna osteotomy is recommended for younger patients to achieve optimal anatomical restoration.
  • Isolated radial osteotomy can be effective if pronation-supination and distal radioulnar joint congruity are achieved.
  • Isolated procedures on the distal ulna are best reserved for elderly patients or those with minimal symptoms.

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