Osteotomy of the Distal Radius Using a Fixed-Angle Volar Plate

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. Results: The mean preoperative deformity was 27° of dorsal tilt of the distal radius, 87° 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

Functional outcome of 2-D- and 3-D-guided corrective forearm osteotomies: a systematic review

“…In total, 53 studies were included in this review (Figure 1) (Aibinder et al., 2018; Andreasson et al., 2020a, 2020b; Athlani et al., 2020; Bauer et al., 2017; Bhatia et al., 2022; Bilgin and Armangil, 2012; Buijze et al., 2012, 2018; Capo et al., 2010; Cha et al., 2021; Delclaux et al., 2016; Dobbe et al., 2021; Elmi et al., 2014; Estermann et al., 2022; Fok et al., 2015; Gaspar et al., 2017; Gradl et al., 2013; Haghverdian et al., 2019; Hsieh et al., 2010; Huang et al., 2019; Izmalkov et al., 2022; Kiliç et al., 2011; Konul and Krimmer, 2012; Lee et al., 2022; Lozano-Calderón et al., 2010; Mahmoud et al., 2012; Michielsen et al., 2018; Miyake et al., 2011, 2012; Mulders et al., 2017; Oka et al., 2018, 2019; de Oliveira et al., 2012; Opel et al., 2014; Ozasa et al., 2013; Pace et al., 2021; Park et al., 2012; Pecache and Calleja, 2020; Pillukat et al., 2013, 2014, 2018; Robinson et al., 2022; Roner et al., 2020; Rothenfluh et al., 2013; Schurko et al., 2020; Shintani et al., 2018; Singh et al., 2022; Stirling et al., 2020; Tarallo et al., 2014; Tiren and Vos, 2014; …”

“…Two randomized controlled trials (Andreasson et al., 2020b; Buijze et al., 2018), two case-control studies (Aibinder et al., 2018; Bauer et al., 2017), 12 cohort studies (Athlani et al., 2020; Bhatia et al., 2022; Dobbe et al., 2021; Kiliç et al., 2011; Mahmoud et al., 2012; Michielsen et al., 2018; Miyake et al., 2012; Oka et al., 2019; Pillukat et al., 2013, 2018, 2014; Tarallo et al., 2014) and 37 case studies (Andreasson et al., 2020a; Bilgin and Armangil, 2012; Buijze et al., 2012; Capo et al., 2010; Cha et al., 2021; Delclaux et al., 2016; Elmi et al., 2014; Estermann et al., 2022; Fok et al., 2015; Gaspar et al., 2017; Gradl et al., 2013; Haghverdian et al., 2019; Hsieh et al., 2010; Huang et al., 2019; Izmalkov et al., 2022; Konul and Krimmer, 2012; Lee et al., 2022; Lozano-Calderón et al., 2010; Miyake et al., 2011; Mulders et al., 2017; Oka et al., 2018; de Oliveira et al., 2012; Opel et al., 2014; Ozasa et al., 2013; Pace et al., 2021; Park et al., 2012; Pecache and Calleja, 2020; Robinson et al., 2022; Roner et al., 2020; Rothenfluh et al., 2013; Schurko et al., 2020; Shintani et al., 2018; Singh et al., 2022; Stirling et al., 2020;…”

The Role of Bone Grafting in Corrective Osteotomy of Distal Radius Malunions

“…As such, the current review cannot draw meaningful conclusions about the influence of cortical contact on union rates. Looking specifically at autograft, three trials used a structural iliac bone graft 17,20,21 and three used cancellous iliac bone graft. 15,18,19 There were two nonunions seen in the study by Henry 4 that used cancellous iliac bone graft, but due to the small number of patients, the current review cannot draw meaningful conclusions regarding the impact of autograft type on the rate to union.…”

“…Six studies, including 93 patients, used autograft with distal radius osteotomy (de Oliveira et al 2012, 17 Henry 2007, 4 Kiliç et al 2011, 18 Miyake et al 2011, 19 Pecache and Calleja 2021, 20 and Rothenfluh et al 2013 21 ). The overall union rate was 98% (91/93).…”

Madelung Deformity: Diagnosis and Treatment Options

“…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.…”