Z-Corrective Osteotomy in Malunited Extra-Articular Fractures of Distal Radius
Copyright © 2022 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved..
PURPOSE: We sought to assess clinical, radiological, and functional outcomes following treatment of extra-articular malunions of the distal radius using a multiplanar z-corrective osteotomy.
METHODS: Fifteen patients with extra-articular distal radius malunions (13 dorsal and 2 volar) underwent z-corrective osteotomy and volar plate fixation without bone grafting. Correction and maintenance of each deformity was evaluated in terms of various radiographic indices (radial height; volar and radial tilt); osteotomy union; pain (visual analog scale); grip strength; range of motion; Disabilities of the Arm, Shoulder, and Hand scores; and Mayo wrist scores.
RESULTS: The mean follow-up was 16.4 months. The mean radial height was corrected from -1.3 mm to 4.9 mm. The mean ulnar variance improved from 4.3 mm to -0.4 mm. The sagittal radial tilt and radial inclination were restored from a mean of -17.9° (dorsal) to 3.3° (volar) and from 12.0° to 17.2°, respectively. The Disabilities of the Arm, Shoulder, and Hand and Mayo wrist scores improved from means of 36 and 56 preoperatively to 24.8 and 73.3, respectively, at 6 months and further to 20.6 and 77.6, respectively, at the last follow-up. There were no nonunions or tendon-related problems. The mean pain score decreased from 4.1 preoperatively to 1.0 at 6 months and 0.8 at the last follow-up. The mean grip strength improved from 5.6 kg preoperatively to 15.6 kg at 6 months and 19.7 kg at the last follow-up. There was a statistically significant improvement in range of motion at the wrist.
CONCLUSIONS: The z-osteotomy provides correction of deformity in all 3 planes, along with restoration of radial height. It also maintains a broad area of bone contact between the 2 osteotomized bone fragments, facilitating bony union and eliminating the need for bone grafting.
TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2022 |
|---|---|
| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:47 |
|---|---|
| Enthalten in: |
The Journal of hand surgery - 47(2022), 6 vom: 22. Juni, Seite 585.e1-585.e10 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Bhatia, Nishant [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Colles’ fracture |
|---|
| Anmerkungen: |
Date Completed 08.06.2022 Date Revised 11.07.2022 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1016/j.jhsa.2021.06.023 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM329642006 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM329642006 | ||
| 003 | DE-627 | ||
| 005 | 20231225205545.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231225s2022 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1016/j.jhsa.2021.06.023 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1098.xml |
| 035 | |a (DE-627)NLM329642006 | ||
| 035 | |a (NLM)34420837 | ||
| 035 | |a (PII)S0363-5023(21)00432-9 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Bhatia, Nishant |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Z-Corrective Osteotomy in Malunited Extra-Articular Fractures of Distal Radius |
| 264 | 1 | |c 2022 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 08.06.2022 | ||
| 500 | |a Date Revised 11.07.2022 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2022 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved. | ||
| 520 | |a PURPOSE: We sought to assess clinical, radiological, and functional outcomes following treatment of extra-articular malunions of the distal radius using a multiplanar z-corrective osteotomy | ||
| 520 | |a METHODS: Fifteen patients with extra-articular distal radius malunions (13 dorsal and 2 volar) underwent z-corrective osteotomy and volar plate fixation without bone grafting. Correction and maintenance of each deformity was evaluated in terms of various radiographic indices (radial height; volar and radial tilt); osteotomy union; pain (visual analog scale); grip strength; range of motion; Disabilities of the Arm, Shoulder, and Hand scores; and Mayo wrist scores | ||
| 520 | |a RESULTS: The mean follow-up was 16.4 months. The mean radial height was corrected from -1.3 mm to 4.9 mm. The mean ulnar variance improved from 4.3 mm to -0.4 mm. The sagittal radial tilt and radial inclination were restored from a mean of -17.9° (dorsal) to 3.3° (volar) and from 12.0° to 17.2°, respectively. The Disabilities of the Arm, Shoulder, and Hand and Mayo wrist scores improved from means of 36 and 56 preoperatively to 24.8 and 73.3, respectively, at 6 months and further to 20.6 and 77.6, respectively, at the last follow-up. There were no nonunions or tendon-related problems. The mean pain score decreased from 4.1 preoperatively to 1.0 at 6 months and 0.8 at the last follow-up. The mean grip strength improved from 5.6 kg preoperatively to 15.6 kg at 6 months and 19.7 kg at the last follow-up. There was a statistically significant improvement in range of motion at the wrist | ||
| 520 | |a CONCLUSIONS: The z-osteotomy provides correction of deformity in all 3 planes, along with restoration of radial height. It also maintains a broad area of bone contact between the 2 osteotomized bone fragments, facilitating bony union and eliminating the need for bone grafting | ||
| 520 | |a TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Colles’ fracture | |
| 650 | 4 | |a Z-osteotomy | |
| 650 | 4 | |a distal radius | |
| 650 | 4 | |a malunited | |
| 700 | 1 | |a Gupta, Ajay |e verfasserin |4 aut | |
| 700 | 1 | |a Dabas, Vineet |e verfasserin |4 aut | |
| 700 | 1 | |a Kataria, Ankit |e verfasserin |4 aut | |
| 700 | 1 | |a Goel, Akash |e verfasserin |4 aut | |
| 700 | 1 | |a Yadav, Akash |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t The Journal of hand surgery |d 1977 |g 47(2022), 6 vom: 22. Juni, Seite 585.e1-585.e10 |w (DE-627)NLM000293652 |x 1531-6564 |7 nnns |
| 773 | 1 | 8 | |g volume:47 |g year:2022 |g number:6 |g day:22 |g month:06 |g pages:585.e1-585.e10 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1016/j.jhsa.2021.06.023 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 47 |j 2022 |e 6 |b 22 |c 06 |h 585.e1-585.e10 | ||