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Distal radius osteotomy in the elderly patient using angular stable implants and Norian bone cement.
Santiago Lozano-Calderón1, Michael Moore, Matthew Liebman
1Hand and Upper Extremity Service, Department of Orthopaedic Surgery, Massachusetts General Hospital-Harvard Medical School, Boston, MA 02114, USA. slozanocalderon@partners.org
This study shows that combining angular-stable locking screws and Norian SRS cement for corrective osteotomies in elderly patients with distal radius fractures is safe and effective. The technique improves alignment and function, avoiding donor site morbidity.
Area of Science:
- Orthopedic Surgery
- Biomaterials Science
Background:
- Distal radius corrective osteotomies are challenging in elderly patients, particularly those with osteoporosis.
- Traditional methods often involve bone grafting, leading to donor site morbidity.
Purpose of the Study:
- To evaluate the efficacy and safety of combining angular-stable locking screw implants with Norian SRS cement for corrective osteotomies of the distal radius in elderly patients.
- To assess if this technique expands treatment options for older individuals with osteoporotic bone.
Main Methods:
- Retrospective study of 6 elderly patients (average age 60) undergoing corrective distal radius osteotomies.
- Utilized angular-stable locking plates and Norian SRS bone cement to fill osseous defects.
- Assessed range of motion, grip strength, radiographic alignment, and patient-reported outcomes (Modified Mayo Wrist, Gartland and Werley, DASH scores).
Main Results:
- All corrective osteotomies healed without perioperative complications.
- Achieved an average sagittal plane correction of 22 degrees and improved ulnar variance by 2 mm.
- Demonstrated good functional recovery with average wrist/forearm motion at 77% and grip strength at 88% of the contralateral side.
Conclusions:
- Corrective osteotomy of the distal radius using angular-stable implants and Norian SRS cement is a safe and predictable procedure in elderly patients, including those with osteoporosis.
- This technique effectively eliminates donor site morbidity.
- Patient-rated outcomes indicate an acceptable return to daily living function.
