Minimally invasive osteotomy for distal radius malunion: A preliminary series of 9 cases.

UNLABELLED The rate of malunion after distal radius fractures is 25% after conservative treatment and 10% after surgery. Their main functional repercussion related to ulno-carpal conflict is loss of wrist motion. We report a retrospective clinical series of minimally invasive osteotomies. The series consisted of 9 cases of minimally invasive osteotomies with volar locking plate fixation. All osteotomies healed. The average pain was 5.3/10 preoperatively and 2.1/10 at last follow-up. The mean Quick DASH was 55.4/100 preoperatively and 24.24/100 at last follow-up. Compared to the opposite side, the average wrist flexion was 84.11%, the average wrist extension was 80.24%, the average pronation was 95.33% and the average supination was 93.9%. With similar results to those of the literature, our short series confirms the feasibility of minimally invasive osteotomy of the distal radius for extra-articular malunion. TYPE: Case-series. LEVEL OF EVIDENCE IV.

[1]  D. Ring,et al.  Osteotomy for malunited fractures of the distal radius: a comparison of structural and nonstructural autogenous bone grafts. , 2002, The Journal of hand surgery.

[2]  J. Capo,et al.  Treatment of extra-articular distal radial malunions with an intramedullary implant. , 2010, The Journal of hand surgery.

[3]  D. Fernández Malunion of the distal radius: current approach to management. , 1993, Instructional course lectures.

[4]  Y. Tropet,et al.  Post-traumatic malunion of the distal radius treated with autologous costal cartilage graft: a technical note on seven cases. , 2011, Orthopaedics & traumatology, surgery & research : OTSR.

[5]  C. Fontaine,et al.  Anatomie vasculaire osseuse à la main et au poignet , 2010 .

[6]  M. Ward,et al.  The shortened disabilities of the arm, shoulder and hand questionnaire (QuickDASH): validity and reliability based on responses within the full-length DASH , 2006, BMC musculoskeletal disorders.

[7]  M. Botte,et al.  Treatment of malunion of the distal radius. , 1987, Hand clinics.

[8]  D. Fernández,et al.  CHAPTER 56 – Osteotomy for Extra-articular Malunion of the Distal Radius , 2009 .

[9]  E. Harvey,et al.  Minimally invasive plate osteosynthesis of distal radius fractures using a pronator sparing approach. , 2008, Techniques in hand & upper extremity surgery.

[10]  Filip Stockmans,et al.  Accuracy of 3D Virtual Planning of Corrective Osteotomies of the Distal Radius , 2013, Journal of Wrist Surgery.

[11]  U. Lanz,et al.  Corrective Osteotomy of the Distal Radius Through Volar Approach , 2004, Techniques in hand & upper extremity surgery.

[12]  A. Zemirline,et al.  Distal radius fixation through a mini-invasive approach of 15 mm. PART 1: a series of 144 cases , 2014, European Journal of Orthopaedic Surgery & Traumatology.

[13]  Y. Tominaga,et al.  Less invasive surgery with wrist arthroscopy for distal radius fracture , 2013, Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association.

[14]  A. Schweizer,et al.  Opening Wedge Osteotomy for Distal Radius Malunion: Dorsal or Palmar Approach? , 2013, Journal of Wrist Surgery.

[15]  J. Hood,et al.  Gradual reduction of distal radial malunion using distraction osteogenesis. , 2007, The Journal of hand surgery.

[16]  D. Vos,et al.  Correction osteotomy of distal radius malunion stabilised with dorsal locking plates without grafting , 2014, Strategies in Trauma and Limb Reconstruction.

[17]  L. Obert,et al.  Extra-articular distal radius malunion: The phosphate cement alternative. , 2010, Orthopaedics & traumatology, surgery & research : OTSR.