Simplifying the Volar Distraction Osteotomy for Distal Radius Malunion Repair

Area of Science:

• Orthopedic Surgery
• Traumatology
• Bone Healing

Background:

• Extra-articular distal radius fractures are often managed nonoperatively, particularly in elderly patients.
• Malunions can develop during nonoperative treatment, necessitating corrective surgery to restore anatomy and function.
• Distal radius malunion presents a significant challenge in orthopedic practice.

Purpose of the Study:

• To describe a novel technique for correcting distal radius malunion.
• To evaluate the clinical and radiographic outcomes of this distraction-type corrective osteotomy.
• To assess the efficacy of a novel resorbable calcium phosphate bone cement in this procedure.

Main Methods:

• A distraction-type volar osteotomy was performed on 13 distal radius malunions in 12 patients.
• A volar plate specific distraction device and a resorbable calcium phosphate bone cement (Trabexus) were utilized.
• Pre- and postoperative radiographic measures (radial inclination, volar tilt, ulnar variance) and clinical assessments (range of motion, grip strength) were compared.

Main Results:

• Statistically significant improvements were observed in volar tilt (-19.8 to +0.5 degrees) and ulnar variance (+2.8 to -0.4 mm).
• Significant gains in grip strength and wrist/forearm range of motion were recorded postoperatively.
• An average of 56.0% of the Trabexus bone substitute remained at final follow-up.

Conclusions:

• The described simplified technique of distraction corrective osteotomy is effective for treating distal radius malunion.
• This approach leads to improved clinical and radiographic outcomes for patients.
• The use of resorbable calcium phosphate bone cement demonstrated good stability and integration.