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Distal Radius Isoelastic Resurfacing Prosthesis: A Preliminary Report
Satoshi Ichihara1, Juan José Hidalgo Díaz2, Brett Peterson3
1Department of Hand Surgery, Strasbourg University Hospitals, FMTS, Strasbourg University, Illkirch, France ; Department of Orthopedic Surgery, Juntendo University, Tokyo, Japan.
Journal of Wrist Surgery
|August 12, 2015
Summary
This study shows that unicompartmental isoelastic resurfacing of the distal radius is a promising treatment for elderly patients with comminuted, osteoporotic wrist fractures, offering functional improvement with manageable complications.
Area of Science:
- Orthopedic Surgery
- Biomaterials Science
- Geriatric Medicine
Background:
- Comminuted, osteoporotic distal radius fractures in elderly patients pose treatment challenges.
- Traditional osteosynthesis may be unsuitable due to poor bone quality and injury severity.
- A novel approach using unicompartmental isoelastic resurfacing prosthesis is explored.
Purpose of the Study:
- To evaluate the efficacy and outcomes of unicompartmental isoelastic resurfacing prosthesis for comminuted, osteoporotic distal radius fractures.
- To assess functional recovery, pain levels, and radiographic results in elderly patients.
- To identify potential complications and their management.
Main Methods:
- A preliminary case series of 12 elderly patients (mean age 76 years) with comminuted osteoporotic distal radius fractures.
- Surgical technique involved a dorsal approach with excision of subchondral bone and application of a unicompartmental prosthesis.
- Outcomes were assessed at an average follow-up of 32 months, including pain, Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) scores, grip strength, and range of motion.
Main Results:
- Significant improvements in wrist range of motion and grip strength were observed compared to the contralateral side.
- Average pain scores were 2.8/10, and average QuickDASH scores were 37.4/100.
- Complications included two cases of complex regional pain syndrome (CRPS) type II (resolved spontaneously), one distal radioulnar joint (DRUJ) stiffness, and one revision surgery for a secondary fracture.
Conclusions:
- Unicompartmental isoelastic resurfacing prosthesis presents a viable and promising treatment option for complex distal radius fractures in osteoporotic elderly patients.
- The procedure demonstrated acceptable functional outcomes and pain relief.
- Careful patient selection and management of potential complications are important for successful outcomes.
