[Post-traumatic correction osteotomy of the distal forearm. Which factors modify the results?].
Post-traumatic deformities are a typical complication of fractures of the distal radius, occurring in about 20% of cases. They are associated with ulno-carpal pain and malfunction of the wrist. Different indications for surgery are given and various operative techniques are recommended. Between 1972 and 1987 a total of 108 patients with post-traumatic disorders following fractures of the distal radius underwent surgical treatment by one of three different procedures: isolated correction of the distal radius, combined correction of the radius und ulna, isolated correction of the ulna (distal resection, shortening osteotomy, hemiresection arthroplasty). 92 (85.2%) followed-up for an average of 9 years postoperatively was possible in 92 (85.2%) of the patients. The functional results were evaluated according to Lidström's system. Excellent and good results were found in 64 (69.6%), fair results in 22 (23.9%), and poor results in 6 (6.5%) of the patients studied. The best results were seen mainly in cases with a short time lapse between trauma and corrective surgery. Distal resection of the ulna has not been performed since 1986 because of poor results and wrist instability. Following isolated correction of radius or ulna, in some patients axial malalignment of the distal radius by about 10 degrees and/or length differences of 2-3 mm with persisting pain or malfunction were seen. In summary, we recommend the combined correction procedure in patients with painful deformities, not more than 6-9 months after the injury. The range of indications should be determined by individual aspects, such as profession, age, activity, discomfort and radiological findings.(ABSTRACT TRUNCATED AT 250 WORDS)
Möllenhoff
G
G
Chirurgische Universitätsklinik und Poliklinik, Berufsgenossenschaftliche Krankenanstalten Bergmannsheil Bochum.
Walz
M
M
Muhr
G
G
Rehn
J
J
D001178:Arthroplasty / Q000379:methods; D006227:Hand Deformities, Acquired / Q000209:etiology* / Q000601:surgery; D006801:Humans; D010027:Osteotomy / Q000379:methods*; D011884:Radius / Q000601:surgery; D011885:Radius Fractures / Q000150:complications / Q000628:therapy*; D014457:Ulna / Q000601:surgery
Posttraumatische Korrekturosteotomien am distalen Unterarm. Welche Faktoren beeinflussen das Ergebnis?