Extra-articular distal radius malunion: The phosphate cement alternative.

UNLABELLED Five consecutive patients (mean age: 40.4 yrs (range, 19-58 yrs)), with symptomatic distal radius malunion underwent corrective opening wedge osteotomy using phosphate cement as an alternative to bone autograft, at a mean 9 months (4-16mo) of fracture. Internal fixation used a plate placed just above the distal radioulnar joint, with soft-tissue release. Radiographic and functional parameters were measured before surgery, and at 6 months and 1 year. At a mean 32.4 months (range, 16-47mo), all patients were satisfied and all the osteotomies were united. At 1 year's follow-up, wrist range of motion reached 75% compared to the contralateral side. Two biopsies performed during plate removal showed osteoid tissue at the cement-bone junction. It is reasonable to consider injectable phosphate cement as a viable alternative to bone grafting in conjunction with surgical correction of distal radius malunion. LEVEL OF EVIDENCE level IV.

[1]  U. Lanz,et al.  [Biomechanical aspects of malunited distal radius fracture. A review of the literature]. , 1999, Handchirurgie, Mikrochirurgie, plastische Chirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Handchirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Mikrochirurgie der Peripheren Nerven und Gefasse : Organ der V....

[2]  J. Thomine.  Fractures du radius distal de l'adulte , 2008 .

[3]  G. Dautel,et al.  [Non-articular malunions of the distal radius: evaluation and techniques of correction]. , 2001, Revue de chirurgie orthopédique et réparatrice de l'appareil moteur.

[4]  Y. Allieu.  Instabilité du carpe — Instabilités ligamentaires et désaxations intracarpiennes — Démembrement du concept d'instabilité du carpe , 1984 .

[5]  J. Jupiter,et al.  Distal radius osteotomy in the elderly patient using angular stable implants and Norian bone cement. , 2007, The Journal of hand surgery.

[6]  M. Geijer,et al.  Osteotomy of dorsally displaced malunited fractures of the distal radius: No loss of radiographic correction during healing with a minimally invasive fixation technique and an injectable bone substitute , 2008, Acta orthopaedica.

[7]  L. Hove,et al.  Corrective osteotomy for malunited extra-articular fractures of the distal radius: A follow-up study of 33 patients , 2007, Scandinavian journal of plastic and reconstructive surgery and hand surgery.