Corrective Osteotomy After Damage of the Distal Radial Physis in Children

Oliveira, Ricardo Kaempf de; Delgado, Pedro J.; Badía, Alejandro; Ferreira, Marco Tonding

doi:10.1097/bth.0b013e31821da4b5

Cited by 8 publications

(4 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The employment of internal fixation systems for osteotomies, with locking plates and screws, reduces the risk of postoperative bone alignment loss, demands less immobilization time, and enables necessary loading for adequate rehabilitation and, besides, avoids the need of additional fixation methods such as Kirschner's wires and/or external fixators. 11,12 In addition, the volar aspect of the distal radius has more room to accommodate the hardware, without the risk of neurotendinous irritation, preventing the need of a second procedure for hardware removal.…”

Section: Discussionmentioning

confidence: 99%

“…Once the osteotomy is performed, the bone cut allows that the radial diaphysis (proximal fragment) is pronated which enhances the access to the posterior wrist for dorsal radius periosteum release, assisting in bone lengthening. 12 Next, the distal epiphysis of the radius is repositioned, so that the support and cover for the lunate bone are increased. The maneuver proceeds with a laminar spreader positioned at the extreme volar and ulnar portion of the osteotomy.…”

Section: Surgical Techniquementioning

confidence: 99%

See 1 more Smart Citation

Shelf Osteotomy for Madelung’s Deformity in Adults: A Novel Technique

Oliveira¹,

Brunelli

Aita

et al. 2021

J Wrist Surg

View full text Add to dashboard Cite

Background Madelung's deformity (MD) comprises increased volar and ulnar tilt of the distal radius joint facet, secondary to an idiopathic physeal dysplasia. Such change causes radial shortening and a consequent distal ulnar prominence, along with wrist pain and loss of motion. Classic surgical techniques are problematic for adults, as they are specific for children and adolescents whose distal radial physis is still open. Description of Technique It is suggested a new treatment method for MD in skeletally mature patients: a distal radius osteotomy and joint realignment are performed through a volar approach to increase the support area of the lunate bone. The rotation and lengthening of the distal epiphysis of the radius generate support and cover to the lunate bone, with improvement of both radiocarpal and distal radioulnar joints. Patients and Methods We describe the technique in details and report the treatment of a 25-year-old female patient. Results Early clinical and radiographic outcomes are encouraging for the treatment of symptomatic patients. Conclusion There is a plethora on the literature about conflicting opinions on the best treatment options and surgical techniques are quite variable, although usually with good results. Besides, the technique here described is indicated during a specific stage of disease presentation, consisting of young adults without any wrist-degenerative changes. Having said that, it is possible to claim that MD treatment with shelf osteotomy is a concept change. Our main goal is to reconstruct the diseased segment and improve wrist stability.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Surgical Techniquementioning

confidence: 99%

Shelf Osteotomy for Madelung’s Deformity in Adults: A Novel Technique

Oliveira¹,

Brunelli

Aita

et al. 2021

J Wrist Surg

View full text Add to dashboard Cite

show abstract

“…Varios autores 47,48 han descrito buenos resultados con el uso de la osteotomía volar del radio distal para diferentes cambios. Como analogía con la displasia de cadera, en la que hay una falta de cobertura acetabular para la cabeza femoral, sugerimos un nuevo método de tratamiento para la DM en pacientes esqueléticamente maduros sin cambios degenerativos.…”

Section: Conceptos De Los Autores En La Literaturaunclassified

Madelung Deformity: Diagnosis and Treatment Options

Oliveira

Ribak

Brunelli

et al. 2021

Revista Iberoamericana de Cirugía de la Mano

View full text Add to dashboard Cite

Madelung deformity (MD) comprises an increased volar and ulnar tilt of the joint facet of the distal radius, secondary to an idiopathic physeal dysplasia. Such change causes radial shortening and consequent distal ulnar prominence, along with wrist pain and loss of motion. Surgery becomes an option in patients with severe deformity that do not respond to conservative treatment.The classic surgical techniques are problematic for adults, as they are specific for children and adolescents, whose radial physis is still open. Very few papers discuss the treatment of adult patients; furthermore, most are focused on the distal radioulnar joint, and thus do not approach the origin of the pathology.When analyzing computed tomography scans with tridimensional reconstruction, a feature of MD, growth arrest of the volar and ulnar portions of the distal radius, is noted, causing the typical distal radius deformity that leads to lack of coverage of the lunate bone. That leads to palmar subluxation of the lunate bone and consequent radiocarpal instability.We herein describe the possibilities of treatment in different stages of evolution, summarizing the authors' view on MD.

show abstract

“…4 A fixed-angle plate can be used as a lever device to correct the deformity. 5 When there is only radial shortening, simple radius lengthening will suffice.…”

mentioning

confidence: 99%

Functional Outcomes after Corrective Osteotomy of Symptomatic Distal Radius Malunions in Children

et al. 2019

View full text Add to dashboard Cite

Background Closed reduction and cast immobilization of displaced distal radius fractures carries the risk of secondary displacement, which could result in a symptomatic malunion. In patients with a symptomatic malunion, a corrective osteotomy can be performed to improve pain and functional impairment of the wrist joint. Objective The aim of this study was to assess the functional outcomes of children who underwent a corrective osteotomy due to a symptomatic malunion of the distal radius. Methods Between 2009 and 2016, all consecutive corrective osteotomies of the distal radius of patients younger than 18 years were reviewed. The primary outcome was functional outcome assessed with the ABILHAND-Kids score. Secondary outcomes were QuickDASH (Quick Disabilities of Arm, Shoulder, and Hand) score, range of motion, complications, and radiological outcomes. Results A total of 13 patients with a median age of 13 years (interquartile range [IQR]: 12.5–16) were included. The median time to follow-up was 31 months (IQR: 26–51). The median ABILHAND-Kids score was 42 (range: 37–42), and the median QuickDASH was 0 (range: 0–39). Range of motion did not differ significantly between the injured and the uninjured sides for all parameters. One patient had a nonunion requiring additional operative treatment. The postoperative radiological parameters showed an improvement of radial inclination, radial height, ulnar variance, dorsal tilt, and dorsal tilt. Conclusion Corrective osteotomy for children is an effective method for treating symptomatic malunions of the distal radius. Level of Evidence This is a Level IV study.

show abstract

Corrective Osteotomy After Damage of the Distal Radial Physis in Children

Cited by 8 publications

References 11 publications

Shelf Osteotomy for Madelung’s Deformity in Adults: A Novel Technique

Shelf Osteotomy for Madelung’s Deformity in Adults: A Novel Technique

Madelung Deformity: Diagnosis and Treatment Options

Functional Outcomes after Corrective Osteotomy of Symptomatic Distal Radius Malunions in Children

Contact Info

Product

Resources

About