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Malunited extra-articular distal radius fractures: corrective osteotomies using volar locking plate

BACKGROUND: Multiple techniques for corrective osteotomy have been developed in recent years with the same aims: to improve the radiographic parameters and improve motion, pain and grip strength. Volar fixed-angle plates have added a new concept to the treatment of distal radius fractures thanks to...

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Autores principales: Tarallo, Luigi, Mugnai, Raffaele, Adani, Roberto, Catani, Fabio
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer International Publishing 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4244554/
https://www.ncbi.nlm.nih.gov/pubmed/25017024
http://dx.doi.org/10.1007/s10195-014-0307-x
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author Tarallo, Luigi
Mugnai, Raffaele
Adani, Roberto
Catani, Fabio
author_facet Tarallo, Luigi
Mugnai, Raffaele
Adani, Roberto
Catani, Fabio
author_sort Tarallo, Luigi
collection PubMed
description BACKGROUND: Multiple techniques for corrective osteotomy have been developed in recent years with the same aims: to improve the radiographic parameters and improve motion, pain and grip strength. Volar fixed-angle plates have added a new concept to the treatment of distal radius fractures thanks to the low morbidity of the surgical approach and the strength of the final construct, allowing early mobilization and return to function. MATERIALS AND METHODS: Between 2005 and 2012, 20 patients with symptomatic dorsally malunited extra-articular fractures of the distal radius underwent corrective osteotomy using a volar locking plate without additional bone graft. At a mean follow-up of 50 months, all the patients were clinically and functionally evaluated. RESULTS: All measurements of pain, final range of motion and grip strength significantly improved compared with preoperative measurements. The mean preoperative DASH score reduced from 54 points preoperatively to 25 postoperatively. Based on the modified Mayo wrist score, we obtained 14 excellent and six good results. Palmar tilt improved from an average of 23° to 11°. Radial inclination improved from an average of 29° to 22°, and ulnar variance decreased from an average of 3.6 mm to 0.9 mm. There were two cases of transient median neuroapraxia that resolved before the 6-week follow-up appointment. No other major complications, including non-union and infection, were observed. CONCLUSION: The volar approach and locking plate, without necessarily the use of bone grafting, proved to be an effective approach for addressing symptomatic and even severe deformities of the distal radius. TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV
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spelling pubmed-42445542014-12-02 Malunited extra-articular distal radius fractures: corrective osteotomies using volar locking plate Tarallo, Luigi Mugnai, Raffaele Adani, Roberto Catani, Fabio J Orthop Traumatol Original Article BACKGROUND: Multiple techniques for corrective osteotomy have been developed in recent years with the same aims: to improve the radiographic parameters and improve motion, pain and grip strength. Volar fixed-angle plates have added a new concept to the treatment of distal radius fractures thanks to the low morbidity of the surgical approach and the strength of the final construct, allowing early mobilization and return to function. MATERIALS AND METHODS: Between 2005 and 2012, 20 patients with symptomatic dorsally malunited extra-articular fractures of the distal radius underwent corrective osteotomy using a volar locking plate without additional bone graft. At a mean follow-up of 50 months, all the patients were clinically and functionally evaluated. RESULTS: All measurements of pain, final range of motion and grip strength significantly improved compared with preoperative measurements. The mean preoperative DASH score reduced from 54 points preoperatively to 25 postoperatively. Based on the modified Mayo wrist score, we obtained 14 excellent and six good results. Palmar tilt improved from an average of 23° to 11°. Radial inclination improved from an average of 29° to 22°, and ulnar variance decreased from an average of 3.6 mm to 0.9 mm. There were two cases of transient median neuroapraxia that resolved before the 6-week follow-up appointment. No other major complications, including non-union and infection, were observed. CONCLUSION: The volar approach and locking plate, without necessarily the use of bone grafting, proved to be an effective approach for addressing symptomatic and even severe deformities of the distal radius. TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV Springer International Publishing 2014-07-15 2014-12 /pmc/articles/PMC4244554/ /pubmed/25017024 http://dx.doi.org/10.1007/s10195-014-0307-x Text en © The Author(s) 2014 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is distributed under the terms of the Creative Commons Attribution License which permits any use, distribution, and reproduction in any medium, provided the original author(s) and the source are credited.
spellingShingle Original Article
Tarallo, Luigi
Mugnai, Raffaele
Adani, Roberto
Catani, Fabio
Malunited extra-articular distal radius fractures: corrective osteotomies using volar locking plate
title Malunited extra-articular distal radius fractures: corrective osteotomies using volar locking plate
title_full Malunited extra-articular distal radius fractures: corrective osteotomies using volar locking plate
title_fullStr Malunited extra-articular distal radius fractures: corrective osteotomies using volar locking plate
title_full_unstemmed Malunited extra-articular distal radius fractures: corrective osteotomies using volar locking plate
title_short Malunited extra-articular distal radius fractures: corrective osteotomies using volar locking plate
title_sort malunited extra-articular distal radius fractures: corrective osteotomies using volar locking plate
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4244554/
https://www.ncbi.nlm.nih.gov/pubmed/25017024
http://dx.doi.org/10.1007/s10195-014-0307-x
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