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Updated: May 27, 2025

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Palmar Z-Osteotomy for Distal Radius Fractures.

Hui Neng Lim1, Mala Satku1, Jieying Xu1

  • 1Department of Hand and Reconstructive Microsurgery, Tan Tock Seng Hospital, Singapore.

The Journal of Hand Surgery Asian-Pacific Volume
|February 18, 2025
PubMed
Summary

A novel Z-osteotomy technique effectively addresses challenges in surgically fixing distal radius fractures (DRFs) with intact volar cortices. This method ensures anatomical reduction and good patient outcomes.

Keywords:
Distal radius fracturesMalunited fixation techniquesRetrospective studyVolar approachVolar osteotomy technique

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Area of Science:

  • Orthopedic Surgery
  • Traumatology
  • Skeletal Biomechanics

Background:

  • Distal radius fractures (DRFs) are prevalent injuries requiring surgical intervention.
  • Palmar plating is standard for DRF fixation, but challenges arise with intact volar cortices.
  • Accurate reduction of volar tilt is crucial for optimal DRF treatment.

Purpose of the Study:

  • To introduce and evaluate a novel volar Z-osteotomy technique for DRFs.
  • To assess the efficacy of this technique in achieving anatomical reduction.
  • To report clinical and radiological outcomes of the Z-osteotomy in DRF management.

Main Methods:

  • Retrospective review of patients undergoing volar Z-osteotomy for DRFs.
  • Analysis of pre-, intra-, and postoperative radiographic parameters.
  • Assessment of fracture union and final wrist range of motion.

Main Results:

  • Twelve DRFs in 11 patients were analyzed.
  • All fractures achieved successful palmar plating with an average volar tilt of 11.3 degrees.
  • All cases demonstrated successful fracture union and good wrist range of motion.

Conclusions:

  • The volar Z-osteotomy technique facilitates anatomical reduction of volar tilt in DRFs with intact volar cortices.
  • This technique yields favorable clinical and radiological outcomes.
  • It offers a viable solution for challenging DRF cases requiring palmar fixation.