DOS BULLETIN - Dansk Ortopædisk Selskab

2010-378_DOS nr. 3 2010 29/09/10 10:08 Side 84
Corrective osteotomy for malunion of the distal radius
fractures. A retrospective study
I.A El-Mansour, G.H Kejlaa, H. Thromborg
Department for Orthopedic Surgery,
Odense University Hospital, Svendborg
Background: Malunion is one of the most common complications of distal
radius fractures which causes significant disturbance of wrest function due to
limited wrest motion and pain. Corrective osteotomy of malunited distal radius
is often registered postoperatively functional and radiological improving.
Purpose: This study presents the clinical and radiological outcome in a case
series of 20 patients with corrective osteotomy for malunion of the distal radius
fractures which was performed in the period 1th January 2007 – 4th December
2007.
Methods: Patients with pain, movement and functional problems were corrected
with open wedge bi-or tri planner osteotomy of the radius, mostly radiopalmar
approach and with interposition of corticocancellous bone autograft from
the iliac crest. The osteotomy was fixed by AO-T plates and screws. At followup
period, the objective pain status, joint movement and functional evaluation of
the wrist were performed according to Fernandez Scale. The post surgical radiographs
status and wrist complications were assessed.
Findings: Pain: (Excellent – none, Good – none, Fair – moderate during exercise,
poor – constant) 12 ptt. – none pain, 5 ptt. – moderate pain, 3 ptt. constant
pain, total no – 20 Range of movement: (per cent of normal – full 100%, 65-100
%, 40- 64 %, 0-39 %) 4 ptt. – full, 7 ptt. > 65 %, 8 ptt. 40-64 %, 1 ptt. < 40 %,
total no 20 Grip strength: (per cent of normal – 80-100 %, 70-80 %, 50-70 %)
4 ptt. > 80 %, 13 ptt. 70-80 %, 3 ptt. >50 %, total no 20 Deformity: 15 ptt. invisible,
5 ptt. slight. The average joint movement was improved in all cases . Average
movement in degrees: DF - 59, VF - 58, RD - 17, UD - 30, P - 68, S – 67
Normal: DF – 80, VF – 80, RD – 30, UD – 40, P – 90, S – 90 The average radiographic
appearance in degrees before and after correction. Before: DA 23,5, VA
23,7, UPV mm 10, RI 12,1 After: DA 10,0, VA 10,0, UPV mm