Posttraumatic distal radius growth arrest treatment by ilizarov distraction osteogenesis

Abstract

Background: Posttraumatic distal radius growth arrest is a challenging orthopedic condition, due to a combination of several deformity components including shortening, angulation and joint line malorientation. It can drastically affect both the function and the shape of the wrist and forearm. However, little has been written about this problem. Patients and Methods: In this retrospective study, seven adolescent patients were operated in our department. All had posttraumatic distal radius growth arrest that resulted in shortening with or without angular deformity. The management consisted of distal radius metaphyseal osteotomy and distraction osteogenesis using Ilizarov frame. The patients' ages ranged from 12 to 15 years. The mean shortening of the radius was 2.2 cm. Correction was assessed radiologically (radial length, joint orientation line) and clinically by Mayo Wrist Score. Results: The mean external fixation time was 2.4 months (range from 2 to 3 months). The mean total treatment time was 12.3 weeks (range from 12 to 16 weeks). The mean bone healing index was 1.13 months/cm. The Mayo Wrist Score mean was 85.7 (range: 75–95) points. According to the Mayo Wrist Score, results were excellent in three patients, good in three patients, satisfactory in one patient with no unsatisfactory results. Superficial pin tract infection occurred in all cases and was managed without further sequelae. Conclusion: Distraction osteogenesis, by Ilizarov external fixator, addresses the sequelae of posttraumatic distal radius growth arrest by restoring the normal anatomy in a controlled biological manner, without further grafting procedures through a minimally invasive approach.