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Corrective distal radius osteotomy following fracture malunion using a fixed-angle volar locking plate
1Department of Trauma and Orthopaedics, University College Hospital, London, UK.
The Journal of Hand Surgery, European Volume
|September 21, 2013
Summary
Corrective osteotomy using a fixed-angle volar locking plate effectively treats post-traumatic distal radius malunion. This surgical approach shows promising short-term results with significant functional and radiological improvements in wrist alignment.
Area of Science:
- Orthopedic Surgery
- Traumatology
- Hand Surgery
Background:
- Post-traumatic distal radius deformity can lead to significant morbidity.
- Symptomatic malunion often necessitates corrective osteotomy to restore wrist function.
- Accurate realignment of the wrist's functional axis is crucial for optimal outcomes.
Purpose of the Study:
- To evaluate the short-term outcomes of corrective osteotomies for distal radius malunion.
- To assess the efficacy of using a fixed-angle volar locking plate in these procedures.
- To review a single surgeon's experience with this surgical technique.
Main Methods:
- Retrospective review of 20 patients (16 women, average age 57) who underwent corrective osteotomy for distal radius malunion.
- All patients were treated using a fixed-angle volar locking plate.
- Short-term follow-up averaged 14 months (range 12-15 months).
Main Results:
- All 20 cases achieved radiological union by an average of 3 months post-surgery.
- No complications were reported during the short-term follow-up period.
- Statistically significant improvements were observed in ulnar variance, radial inclination, dorsal tilt, and supination, with an average post-operative Disability of the Arm, Shoulder and Hand (DASH) score of 13.48.
Conclusions:
- Corrective osteotomy with a fixed-angle volar locking plate is a safe and effective treatment for post-traumatic distal radius malunion.
- The procedure leads to favorable short-term radiological union and functional recovery.
- This technique offers objective improvements in wrist biomechanics and patient-reported outcomes.
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