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Accuracy of 3D Corrective Osteotomy for Pediatric Malunited Both-Bone Forearm Fractures

Re-displacement of a pediatric diaphyseal forearm fracture can lead to a malunion with symptomatic impairment in forearm rotation, which may require a corrective osteotomy. Corrective osteotomy with two-dimensional (2D) radiographic planning for malunited pediatric forearm fractures can be a complex...

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Autores principales: Roth, Kasper, van Es, Eline, Kraan, Gerald, Eygendaal, Denise, Colaris, Joost, Stockmans, Filip
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9856311/
https://www.ncbi.nlm.nih.gov/pubmed/36670572
http://dx.doi.org/10.3390/children10010021
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author Roth, Kasper
van Es, Eline
Kraan, Gerald
Eygendaal, Denise
Colaris, Joost
Stockmans, Filip
author_facet Roth, Kasper
van Es, Eline
Kraan, Gerald
Eygendaal, Denise
Colaris, Joost
Stockmans, Filip
author_sort Roth, Kasper
collection PubMed
description Re-displacement of a pediatric diaphyseal forearm fracture can lead to a malunion with symptomatic impairment in forearm rotation, which may require a corrective osteotomy. Corrective osteotomy with two-dimensional (2D) radiographic planning for malunited pediatric forearm fractures can be a complex procedure due to multiplanar deformities. Three-dimensional (3D) corrective osteotomy can aid the surgeon in planning and obtaining a more accurate correction and better forearm rotation. This prospective study aimed to assess the accuracy of correction after 3D corrective osteotomy for pediatric forearm malunion and if anatomic correction influences the functional outcome. Our primary outcome measures were the residual maximum deformity angle (MDA) and malrotation after 3D corrective osteotomy. Post-operative MDA > 5° or residual malrotation > 15° were defined as non-anatomic corrections. Our secondary outcome measure was the gain in pro-supination. Between 2016–2018, fifteen patients underwent 3D corrective osteotomies for pediatric malunited diaphyseal both-bone fractures. Three-dimensional corrective osteotomies provided anatomic correction in 10 out of 15 patients. Anatomic corrections resulted in a greater gain in pro-supination than non-anatomic corrections: 70° versus 46° (p = 0.04, ANOVA). Residual malrotation of the radius was associated with inferior gain in pro-supination (p = 0.03, multi-variate linear regression). Three-dimensional corrective osteotomy for pediatric forearm malunion reliably provided an accurate correction, which led to a close-to-normal forearm rotation. Non-anatomic correction, especially residual malrotation of the radius, leads to inferior functional outcomes.
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spelling pubmed-98563112023-01-21 Accuracy of 3D Corrective Osteotomy for Pediatric Malunited Both-Bone Forearm Fractures Roth, Kasper van Es, Eline Kraan, Gerald Eygendaal, Denise Colaris, Joost Stockmans, Filip Children (Basel) Article Re-displacement of a pediatric diaphyseal forearm fracture can lead to a malunion with symptomatic impairment in forearm rotation, which may require a corrective osteotomy. Corrective osteotomy with two-dimensional (2D) radiographic planning for malunited pediatric forearm fractures can be a complex procedure due to multiplanar deformities. Three-dimensional (3D) corrective osteotomy can aid the surgeon in planning and obtaining a more accurate correction and better forearm rotation. This prospective study aimed to assess the accuracy of correction after 3D corrective osteotomy for pediatric forearm malunion and if anatomic correction influences the functional outcome. Our primary outcome measures were the residual maximum deformity angle (MDA) and malrotation after 3D corrective osteotomy. Post-operative MDA > 5° or residual malrotation > 15° were defined as non-anatomic corrections. Our secondary outcome measure was the gain in pro-supination. Between 2016–2018, fifteen patients underwent 3D corrective osteotomies for pediatric malunited diaphyseal both-bone fractures. Three-dimensional corrective osteotomies provided anatomic correction in 10 out of 15 patients. Anatomic corrections resulted in a greater gain in pro-supination than non-anatomic corrections: 70° versus 46° (p = 0.04, ANOVA). Residual malrotation of the radius was associated with inferior gain in pro-supination (p = 0.03, multi-variate linear regression). Three-dimensional corrective osteotomy for pediatric forearm malunion reliably provided an accurate correction, which led to a close-to-normal forearm rotation. Non-anatomic correction, especially residual malrotation of the radius, leads to inferior functional outcomes. MDPI 2022-12-23 /pmc/articles/PMC9856311/ /pubmed/36670572 http://dx.doi.org/10.3390/children10010021 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Roth, Kasper
van Es, Eline
Kraan, Gerald
Eygendaal, Denise
Colaris, Joost
Stockmans, Filip
Accuracy of 3D Corrective Osteotomy for Pediatric Malunited Both-Bone Forearm Fractures
title Accuracy of 3D Corrective Osteotomy for Pediatric Malunited Both-Bone Forearm Fractures
title_full Accuracy of 3D Corrective Osteotomy for Pediatric Malunited Both-Bone Forearm Fractures
title_fullStr Accuracy of 3D Corrective Osteotomy for Pediatric Malunited Both-Bone Forearm Fractures
title_full_unstemmed Accuracy of 3D Corrective Osteotomy for Pediatric Malunited Both-Bone Forearm Fractures
title_short Accuracy of 3D Corrective Osteotomy for Pediatric Malunited Both-Bone Forearm Fractures
title_sort accuracy of 3d corrective osteotomy for pediatric malunited both-bone forearm fractures
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9856311/
https://www.ncbi.nlm.nih.gov/pubmed/36670572
http://dx.doi.org/10.3390/children10010021
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