Osteotomias do rádio distal com uso de placa volar de ângulo fixo

Abstract

Objective: Skewed consolidation of the distal radius, due to sequelae of fractures, may cause functional incapacity, thus leading such patients to present pain, loss of strength and diminished mobility. Based on the excellent results obtained from surgical treatment of unstable fractures of the distal radius through a volar approach and use of rigid fixation with a fixed-angle volar plate, we started to use the same method for osteotomy of the distal radius. Methods: A retrospective review was conducted, and 20 patients treated between February 2002 and October 2009 were found. The mean length of follow-up was 43.9 months (range: 12 to 96 months). The surgical indications were persistent pain, deformity and functional limitation subsequent to a dorsally displaced fracture. Rev Bras Ortop. 2012;47(2):173-85Results: The mean preoperative deformity was 27º of dorsal tilt of the distal radius, 87º of ulnar tilt, and 7.3 mm of shortening of the radius. All the osteotomies consolidated and the final mean volar tilt was 6.2°, with ulnar tilt of 69.3° and shortening of 1 mm. The mean mobility of the wrist increased by 19.9° (flexion) and by 24° (extension). Mean forearm supination increased by 23.5° and pronation by 21.7°. Grip strength increased from 13.4 to 34.5 pounds. Conclusion: Use of a fixed-angle volar plate for a volar approach towards osteotomy of the distal radius enables satisfactory correction of the deformities and eliminates the need for removal of the synthesis material caused by tendon complications

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

“…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.…”