Distal Radius Isoelastic Resurfacing Prosthesis: A Preliminary Report.
Background Here we present a preliminary case series of unicompartmental isoelastic resurfacing prosthesis of the distal radius to treat comminuted articular fractures of osteoporotic elderly patients. Materials and Methods Our study included 12 patients, mean age 76 years, who presented with comminuted osteoporotic distal radius fracture. Because of the severity of injury and poor bone quality; osteosynthesis was not deemed to be a good option. Description of Technique The surgery was performed through a dorsal approach. The subchondral bone of the entire distal radial articular was excised and a unicompartmental prosthesis was applied. Results At an average follow-up of 32 months, the pain was 2.8/10, Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) 37.4/100, grip strength in neutral 49.9%, in supination 59.0%, and in pronation 56.2% of the contralateral normal side. The wrist ranges of motion in flexion and extension were 56.1% and 79.3%, in supination and pronation 87.7% and 91.0% of the contralateral normal side. Two patients experienced a complex regional pain syndrome (CRPS) type II; these resolved spontaneously. One patient experienced distal radioulnar joint (DRUJ) stiffness, which improved after an ulna head resection. Finally, one patient required revision surgery after a secondary traumatic fracture. Radiographically; the average volar tilt was 9.8°; the average of radial inclination was 11.6°. Conclusion The concept of a unicompartmental isoelastic resurfacing prosthesis offers a promising option for the treatment of comminuted, osteoporotic distal radius articular fractures of elderly patients. Level of Evidence IV.
Department of Hand Surgery, Strasbourg University Hospitals, FMTS, Strasbourg University, Illkirch, France ; Department of Orthopedic Surgery, Juntendo University, Tokyo, Japan.
Satoshi
S
Ichihara
Department of Hand Surgery, Strasbourg University Hospitals, FMTS, Strasbourg University, Illkirch, France.
Juan José Hidalgo
JJ
Díaz
Department of Orthopedic Surgery, UC Irvine, Irvine, California.
Brett
B
Peterson
Department of Hand Surgery, Strasbourg University Hospitals, FMTS, Strasbourg University, Illkirch, France.
Sybille
S
Facca
Department of Plastic Surgery, Strasbourg University Hospitals, FMTS, University of Strasbourg, Strasbourg, France.
Frédéric
F
Bodin
Department of Hand Surgery, Strasbourg University Hospitals, FMTS, Strasbourg University, Illkirch, France.
Philippe
P
Liverneaux
distal radius fracture; elderly; hemi-prosthesis; osteoporosis; unicompartmental isoelastic resurfacing prosthesis; wrist prosthesis