[Pro- and supination impairments due to torsional deformities of the radial diaphysis before and after ulna osteotomy].
The aim of this experimental study was to measure the exact influence of torsional deformities at the middle third of the radial shaft before and after osteotomy of the ulnar shaft on the rotation of the forearm. Intact and fresh cadaver specimens were fixed in a newly developed apparatus that allowed free pronation and supination. A ring fixator was applied to the radial shaft with K wires that allowed torsional deformities to be stabilized in steps of 10 degrees. The middle of the radial shaft was osteotomized via a small soft tissue window leaving the other soft tissues including the interosseous membrane intact. Supination and pronation were measured using a goniometer in a standardized fashion. The mean supination value before osteotomy of the radius was 71.6 degrees [standard deviation (SD)15.2 degrees], the mean pronation value was 64.5 degrees (SD 12.4 degrees). Radial osteotomy caused no significant difference in the range of motion prior to creation of torsional deformities. Supination torsional deformities greater than 30 degrees showed a significant loss of pronation and pronation torsional deformities greater than 30 degrees resulted in a significant loss of supination in 14 fresh cadavers, respectively. The amount of mean rotational loss was approximately the same in the respective pronation and supination torsional deformities. In the next step the influence of an ulna osteotomy on the range of motion was evaluated in different torsional deformities. In the four cadavers measured, there was an increase of the range of motion in the direction of the torsional deformity. These values were not significant when compared to values before ulna osteotomy, but there were significant changes to the non deformity (p=0.004 for pronation, p=0.003 for supination). Impairment of range of motion in the opposite direction of the deformity showed a similar appearance as values before ulna osteotomy. Again, there were significant changes to the non deformity (p=0.003 for pronation, p=0.005 for supination).
Kasten
P
P
Ortopädische Universitätsklinik Heidelberg, Germany.
Krefft
M
M
Schneider
S
S
Hesselbach
J
J
Weinberg
A-M
AM
D000328:Adult; D002102:Cadaver; D004551:Elbow Joint / Q000503:physiopathology* / Q000601:surgery*; D005260:Female; D006801:Humans; D066298:In Vitro Techniques; D007593:Joint Instability / Q000209:etiology / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D010027:Osteotomy / Q000009:adverse effects* / Q000379:methods; D011884:Radius / Q000503:physiopathology*; D016059:Range of Motion, Articular; D014102:Torsion Abnormality / Q000503:physiopathology; D014457:Ulna / Q000503:physiopathology* / Q000601:surgery*