Immediate mobilisation following corrective osteotomy of distal radius malunions with cancellous graft and volar fixed angle plates.
The purpose of the study was to examine the reliability with which a specific technique of corrective osteotomy of malunions of the distal radius combined with early mobilisation could both restore the normal anatomic parameters of the radius and achieve a functional range of motion with good strength. Corrective osteotomy of the distal radius was performed through a volar approach using a fixed angle volar plate and cancellous bone graft from the iliac crest in 19 patients of mean age 50 years with initial malunions with a mean dorsal tilt of 36 degrees and 7 mm of ulnar variance. An immediate mobilisation programme was started. All healed at a mean of less than 12 weeks (including two heavy smoking patients who required repeat cancellous bone grafting to achieve final union) to achieve a total arc of wrist motion around 120 degrees, forearm rotation of 158 degrees and grip strength which was 80% of contralateral. This treatment strategy was judged to be straightforward and effective.
Henry
M
M
Hand and Wrist Center of Houston, Department of Orthopaedic Surgery, University of Texas, Houston, Texas 77004, USA. mhenry@houstonhand.com
D000328:Adult; D000368:Aged; D001860:Bone Plates; D016025:Bone Transplantation; D004434:Early Ambulation; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal; D017759:Fractures, Malunited / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010027:Osteotomy; D011183:Postoperative Complications / Q000000981:diagnostic imaging; D011856:Radiographic Image Enhancement; D011885:Radius Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D016059:Range of Motion, Articular / Q000502:physiology; D020127:Recovery of Function / Q000502:physiology; D014954:Wrist Injuries / Q000000981:diagnostic imaging / Q000601:surgery*