Malunion Of Distal Radius Fracture Research Articles

THE SAUVÉ-KAPANDJI PROCEDURE IN COMBINATION WITH OPENING RADIAL WEDGE OSTEOTOMY FOR MALUNION OF DISTAL RADIUS FRACTURES

The Sauvé-Kapandji procedure in combination with an opening radial wedge osteotomy for malunion of distal radius fractures was performed in six patients. Follow-up at an average of 40.3 months showed two excellent, three good, and one poor result. Satisfactory results were obtained in restoration of forearm rotation and improvement of pain in all patients. The Sauvé-Kapandji procedure in addition to an opening radial wedge osteotomy was indicated when a preoperative limitation of forearm rotation with severe pain and radiographic evidence of degenerative changes in the distal radioulnar joint were present. We have found combining these two procedures to be a reliable treatment option for malunion of distal radius fractures.

A SYSTEMATIC APPROACH TO HANDLING THE DISTAL RADIO-ULNAR JOINT IN CASES OF MALUNITED DISTAL RADIUS FRACTURES

The distal radio-ulnar joint (DRUJ) is often the site of persistent symptoms after malunion of distal radius fractures. These malunions alter load transfer across the ulnocarpal joint, disturb DRUJ kinematics, and result in joint incongruity at the sigmoid notch. Treatment of distal radius malunions must not only correct position of the radial platform and joint incongruity but also restore anatomic relationship at the DRUJ. A systematic approach to the surgical reconstruction of these multiplanar deformities using clinical and radiographic parameters is outlined.

A Minimally Invasive Distal Radial Osteotomy for Treatment of Distal Radius Fracture Malunion

A Minimally Invasive Distal Radial Osteotomy for Treatment of Distal Radius Fracture Malunion

Effects of distal radius fracture malunion on wrist joint mechanics

An experimental model using a static positioning frame, pressure-sensitive film (Fuji), and a microcomputer-based videodigitizing system was used to measure contact areas and pressures in the wrist. Contact areas and pressures were compared in a group of wrists between the normal state and with simulated distal radius fracture malunions of varying degrees. In simulated malunions, radial shortening to any degree slightly increased the total contact area in the lunate fossa, and was significant at 2 mm of shortening. By angulating the distal radius more than 20 degrees either palmar or dorsal, there was a dorsal shift in the scaphoid and lunate high pressure areas, and the loads were more concentrated, but there was no change in the load distribution between the scaphoid and lunate. Decreasing the radial inclination shifted the load distribution so that there was more load in the lunate fossa and less load in the scaphoid fossa.

Korrektarosteotomie nach peripheren Radiusfrakturen. Methode und Ergebnisse

Malunion of distal radius fractures leads, especially in those patients who are manually employed, to functional disability of the hand. Painful impingement on the ulnar side of the wrist results in decreased range of motion in pronation/supination and loss of strength. By reconstructing as precisely as possible the axial and longitudinal relationship of the forearm bones, the desired congruence of the distal radioulnar joint can be achieved, this improving greatly the strength and function of the hand. Indications, point of time, as well as technique in operating will be presented in short form in 42 of our own cases: complications will also be discussed. The roentgenographic and functional results, as well as the subjective evaluation from 33 patients whose operations took place longer than a year ago, before and after the malunion correction, will be listed according to our postoperative examination protocol for radius fractures. In all three parameters positive results could be shown, especially in the patient's subjective analysis. Notice will be taken on the special difficulties in position corrections in cases in which the ulnar side fragment is dislocated.