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Combined radius addition osteotomy and ulnar shortening to correct extra-articular distal radius fracture malunion with severe radial deviation and ulnar plus

Malunion can occur in 11 to 28% of Distal Radius Fractures and can result in radius shortening and ulnar plus with wrist deviation, pain and disability. We aimed to report particular cases of extra-articular distal radius fracture malunion with severe radial deviation and ulnar plus treated by corre...

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Autores principales: Marcuzzi, Augusto, Lana, Debora, Laselva, Onofrio, Pogliacomi, Francesco, Leigheb, Massimiliano, Adani, Roberto
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Mattioli 1885 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7233694/
https://www.ncbi.nlm.nih.gov/pubmed/31821303
http://dx.doi.org/10.23750/abm.v90i12-S.8990
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author Marcuzzi, Augusto
Lana, Debora
Laselva, Onofrio
Pogliacomi, Francesco
Leigheb, Massimiliano
Adani, Roberto
author_facet Marcuzzi, Augusto
Lana, Debora
Laselva, Onofrio
Pogliacomi, Francesco
Leigheb, Massimiliano
Adani, Roberto
author_sort Marcuzzi, Augusto
collection PubMed
description Malunion can occur in 11 to 28% of Distal Radius Fractures and can result in radius shortening and ulnar plus with wrist deviation, pain and disability. We aimed to report particular cases of extra-articular distal radius fracture malunion with severe radial deviation and ulnar plus treated by corrective osteotomy of distal radius with bone graft associated to ulnar procedure. One of these patients was firstly operated with ulna subtraction osteotomy synthesized with plate and in a second stage with distal radius corrective addition osteotomy with homologous bone graft, plate and external fixator. Two other cases were treated in a single-step by radius addition osteotomy and caput ulnae Darrach resection. These three patients were followed-up from 2 to 12 years, successfully observing the maintenance of anatomical correction and recovery of ROM and strength with good pain relief and return to daily activities. After Darrach procedure external-fixation wasn’t needed and pronation-supination was better. Darrach procedure can solve ulna plus and improve ROM in pronation-supination with a quicker healing, avoiding the risk of ulnar non-union. Darrach’s procedure associated to addition corrective osteotomy of distal radius can be a valid treatment for distal radius severe malunion, in patients with low-moderate functional demand. In conclusion, the surgeon should choose the right corrective treatment after the complete evaluation of the patient and his functional needs. (www.actabiomedica.it)
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spelling pubmed-72336942020-05-19 Combined radius addition osteotomy and ulnar shortening to correct extra-articular distal radius fracture malunion with severe radial deviation and ulnar plus Marcuzzi, Augusto Lana, Debora Laselva, Onofrio Pogliacomi, Francesco Leigheb, Massimiliano Adani, Roberto Acta Biomed Case Report Malunion can occur in 11 to 28% of Distal Radius Fractures and can result in radius shortening and ulnar plus with wrist deviation, pain and disability. We aimed to report particular cases of extra-articular distal radius fracture malunion with severe radial deviation and ulnar plus treated by corrective osteotomy of distal radius with bone graft associated to ulnar procedure. One of these patients was firstly operated with ulna subtraction osteotomy synthesized with plate and in a second stage with distal radius corrective addition osteotomy with homologous bone graft, plate and external fixator. Two other cases were treated in a single-step by radius addition osteotomy and caput ulnae Darrach resection. These three patients were followed-up from 2 to 12 years, successfully observing the maintenance of anatomical correction and recovery of ROM and strength with good pain relief and return to daily activities. After Darrach procedure external-fixation wasn’t needed and pronation-supination was better. Darrach procedure can solve ulna plus and improve ROM in pronation-supination with a quicker healing, avoiding the risk of ulnar non-union. Darrach’s procedure associated to addition corrective osteotomy of distal radius can be a valid treatment for distal radius severe malunion, in patients with low-moderate functional demand. In conclusion, the surgeon should choose the right corrective treatment after the complete evaluation of the patient and his functional needs. (www.actabiomedica.it) Mattioli 1885 2019 2019-12-05 /pmc/articles/PMC7233694/ /pubmed/31821303 http://dx.doi.org/10.23750/abm.v90i12-S.8990 Text en Copyright: © 2019 ACTA BIO MEDICA SOCIETY OF MEDICINE AND NATURAL SCIENCES OF PARMA http://creativecommons.org/licenses/by-nc-sa/4.0 This work is licensed under a Creative Commons Attribution 4.0 International License
spellingShingle Case Report
Marcuzzi, Augusto
Lana, Debora
Laselva, Onofrio
Pogliacomi, Francesco
Leigheb, Massimiliano
Adani, Roberto
Combined radius addition osteotomy and ulnar shortening to correct extra-articular distal radius fracture malunion with severe radial deviation and ulnar plus
title Combined radius addition osteotomy and ulnar shortening to correct extra-articular distal radius fracture malunion with severe radial deviation and ulnar plus
title_full Combined radius addition osteotomy and ulnar shortening to correct extra-articular distal radius fracture malunion with severe radial deviation and ulnar plus
title_fullStr Combined radius addition osteotomy and ulnar shortening to correct extra-articular distal radius fracture malunion with severe radial deviation and ulnar plus
title_full_unstemmed Combined radius addition osteotomy and ulnar shortening to correct extra-articular distal radius fracture malunion with severe radial deviation and ulnar plus
title_short Combined radius addition osteotomy and ulnar shortening to correct extra-articular distal radius fracture malunion with severe radial deviation and ulnar plus
title_sort combined radius addition osteotomy and ulnar shortening to correct extra-articular distal radius fracture malunion with severe radial deviation and ulnar plus
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7233694/
https://www.ncbi.nlm.nih.gov/pubmed/31821303
http://dx.doi.org/10.23750/abm.v90i12-S.8990
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