Malunion of Pediatric Forearm Shaft Fractures: Management Principles and Techniques

Li, Tuo Peter; Wollstein, Adi; Sabharwal, Samir; Nayar, Suresh K.; Sabharwal, Sanjeev

doi:10.1007/s12178-022-09783-2

Cited by 2 publications

(3 citation statements)

References 48 publications

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“…The conventional approach for acute correction of post-traumatic malunion deformities in children is represented by a corrective osteotomy at the deformity site (mainly closing-wedge osteotomy, opening-wedge osteotomy, or oblique osteotomy) planned on plain radiographs, with or without an additional osteotomy of the other bone, to achieve acceptable ulnar variance and satisfactory prono-supination [ 1 , 2 , 15 , 16 , 17 , 18 , 19 , 20 ]. Since the spread of computer-aided planning and the introduction of PSIs in the last two decades, many different options have become viable to improve surgical accuracy and final outcome [ 1 , 4 , 21 , 22 , 23 , 24 , 25 ].…”

Section: Discussionmentioning

confidence: 99%

“…Currently, acute correction of post-traumatic forearm deformities in children is generally achieved with a closing-wedge osteotomy, an opening-wedge osteotomy, or an oblique osteotomy of one or both bones [ 1 , 2 ]. The precision of these techniques has significantly improved since the introduction of virtual surgical planning (VSP) and the spread of 3D-printed patient-specific instruments (PSIs) in orthopedic surgery [ 1 , 2 , 3 , 4 ]. Many authors have published methods and algorithms to precisely align a malunited bone to the shape of the uninjured contralateral with a single oblique cut [ 5 , 6 , 7 , 8 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

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The Flipping-Wedge Osteotomy: How 3D Virtual Surgical Planning (VSP) Suggested a Simple and Promising Type of Osteotomy in Pediatric Post-Traumatic Forearm Deformity

Depaoli

Menozzi

Gennaro

et al. 2023

JPM

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(1) Background: The application of computer-aided planning in the surgical treatment of post-traumatic forearm deformities has been increasingly widening the range of techniques over the last two decades. We present the “flipping-wedge osteotomy”, a promising geometrical approach to correct uniapical deformities defined during our experience with virtual surgical planning (VSP); (2) Methods: a case of post-traumatic distal radius deformity (magnitude 43°) treated with a flipping-wedge osteotomy in an 11-year-old girl is reported, presenting the planning rationale, its geometrical demonstration, and the outcome of the procedure; (3) Results: surgery achieved correction of both the angular and rotational deformities with a neutral ulnar variance; (4) Conclusions: flipping-wedge osteotomy may be a viable option to achieve correction in forearm deformities, and it deserves further clinical investigation.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The Flipping-Wedge Osteotomy: How 3D Virtual Surgical Planning (VSP) Suggested a Simple and Promising Type of Osteotomy in Pediatric Post-Traumatic Forearm Deformity

Depaoli

Menozzi

Gennaro

et al. 2023

JPM

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“…Considering cadaveric studies, it has been shown that malunion of less than 10° causes minimal pronation and supination limitation, while higher degrees cause significant loss in the same movements [4,5,7]. Surgical treatment is recommended to prevent functional and cosmetic problems [8][9][10].…”

Section: Discussionmentioning

confidence: 99%

Pediatric Forearm Fractures with Unacceptable Angulation: Is Remodeling Effective?

DANIŞMAN,

EMET,

KOÇYİĞİT

et al. 2023

Osmangazi̇ Journal of Medicine

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The aim of this study is to examine the remaining deformity after remodeling and its relationship with pronation/supination limitation in patients with unacceptable angulation according to the literature. 45 patients who had forearm fractures treated with closed reduction and plaster cast between 2014 and 2019 were included in the study. The maximum angulation amount was determined on anteroposterior or lateral radiographs by measuring the angulation of the radius and ulna on the radiographs taken during plaster removal (T1) and on the radiographs after remodeling (T2) at the last follow-up. The average follow-up period was 61.6 months (36-90 months). The patients were divided into 2 groups according to the angulation in the radiographs taken on the day the cast was removed (T1): Group 1 (acceptable angulation), and Group 2 (unacceptable angulation). While the average of maximum angulation values at T1 in Group 1 was 8.2 (±2.6) it was 15.4 (±4.1) in Group 2 (p = 0.002). While the mean residual angulation value at T2 was 3.5 (±1.8) in Group 1, it was 6.8 (±3.1) in Group 2 (p = 0.002). It was determined that 7 of 19 patients in Group 1 and 13 of 26 patients in Group 2 had a limitation of more than 10° (p = 0.382). Conservatively treated pediatric forearm fractures have the potential to heal to normal degrees at a high rate after remodeling, even if they have unacceptable angulation degrees, and the pronation/supination limitation in these patients is not directly related to the residual angulation degrees.

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Malunion of Pediatric Forearm Shaft Fractures: Management Principles and Techniques

Cited by 2 publications

References 48 publications

The Flipping-Wedge Osteotomy: How 3D Virtual Surgical Planning (VSP) Suggested a Simple and Promising Type of Osteotomy in Pediatric Post-Traumatic Forearm Deformity

The Flipping-Wedge Osteotomy: How 3D Virtual Surgical Planning (VSP) Suggested a Simple and Promising Type of Osteotomy in Pediatric Post-Traumatic Forearm Deformity

Pediatric Forearm Fractures with Unacceptable Angulation: Is Remodeling Effective?

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