[A correction technic using an osteotomy-graft in chronic impaction of the radial socket, called "die punch"].
The central crush of the radial glena, so-called "Die-Punch", may be relatively easy to fix, when it is initially recognized. Unfortunately, it is often ignored, which compromises the future of the radio-carpal joint. When this "die-punch" is at the stage of malunion, the cartilage depression is very difficult to reach to. It is the goal of this described technique: through an antero-lateral way, making a sagittal osteotomy guided on a K-wire, aiming at the lateral limit of the crush; the lateral fragment comprising the radial styloide process is then turned like a door around a posterior hinge, opening the access to the medial bony cut, at the lower part of it, the depressed fragment is clearly visible. This fragment is lowered with a chisel of appropriate width, until it joins its proper level; then a fragment of cancellous bone taken in the upper part of the cut is crammed in the room above the "die-punch". The "door" is then closed and fixed with a screw, without any problem of consolidation, so as the rehabilitation may be initiated immediately. The practice of this procedure is till now limited to a few cases (two), but the results are very encouraging. This technique is worthy to be tried by other hand surgeons.
Kapandji
A
A
Clinique de l'Yvette, Longjumeau.
D001863:Bone Screws; D016025:Bone Transplantation / Q000379:methods*; D001864:Bone Wires; D002358:Cartilage, Articular / Q000293:injuries / Q000601:surgery; D017759:Fractures, Malunited / Q000601:surgery; D006801:Humans; D010027:Osteotomy / Q000379:methods*; D011884:Radius / Q000601:surgery; D011885:Radius Fractures / Q000601:surgery*; D016896:Treatment Outcome
Technique de correction par ostéotomie-greffe de l'enfoncement invétéré de la glène radiale, dit "die punch".