The Clinical Results of Opening Wedge Osteotomy in the Volarly Malunited Distal Radius

Seoung Joon Lee; Jin Ho Choi

doi:10.12671/jkfs.2014.27.1.29

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Lee and Choi: The Clinical Results of Opening Wedge Osteotomy in the Volarly Malunited Distal Radius

Original Article

Journal of the Korean Fracture Society 2014; 27(1): 29-35.

Published online: 17 January 2014

DOI: https://doi.org/10.12671/jkfs.2014.27.1.29

The Clinical Results of Opening Wedge Osteotomy in the Volarly Malunited Distal Radius

Seoung Joon Lee, M.D., Ph.D., Jin Ho Choi, M.D.

Department of Orthopedic Surgery, Konkuk University School of Medicine, Seoul, Korea.

Address reprint requests to: Seoung Joon Lee, M.D., Ph.D. Department of Orthopedic Surgery, Konkuk University Medical Center, 120-1 Neungdong-ro, Gwangjin-gu, Seoul 143-729, Korea. Tel: 82-2-2030-7360, Fax: 82-2-2030-7369, lsjmd@naver.com

Received 20 February 2013 Revised 6 July 2013 Accepted 12 October 2013

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To report the clinical results of opening wedge osteotomy graft in the volarly malunited distal radius.

Materials and Methods

Ten patients with volarly malunited distal radius fractures treated by opening wedge osteotomy were included in this study. Grip power, range of motion of the wrist, radiographic parameter and Mayo wrist scores were retrospectively evaluated.

Results

At the final follow-up, the rotation of the forearm, the range of motion of wrist, and the grip power were improved. The average radial inclination improved to 22.2°, the average volar tilting improved to 5.6°, and the average ulnar variance improved to 0.8 mm. The average Mayo wrist score was improved to 85.6.

Conclusion

Opening wedge osteotomy for volarly malunited distal radius was considered as one of the good treatments to restore anatomy of the distal radius and distal radioulnar joint and also to improve the function of the wrist joint.

Keywords: Distal radius, Malunion, Opening wedge osteotomy

Figures and Tables

Fig. 1

Intraoperative photographs show surgical approach (A), wedge osteotomy and wedge shaped iliac bone (B, C, D), and plate fixation (E).

Fig. 2

(A, B) Initial simple radiographs show unstable distal radius fracture. (C, D) Simple radiographs after external fixation and K-wire fixation show radial inclination of 20°, volar tilt 5°, and neutral ulnar variance. (E, F) Simple radiographs after removal of external fixation and K-wire show the volarly malunited distal radius with volar tilt of 25°, 12° radial inclination, 3 mm ulnar positive variance. (G, H) Simple radiographs after open wedge osteotomy show a good alignment of distal radius with volar tilt of 5°, 25° radial inclination, 0 mm ulnar variance.

Fig. 3

(A, B) Initial simple radiographs show Colles' fracture with ulnar styloid fracture. (C, D) Simple radiographs after closed reduction and splinting show a good alignment of distal radius. (E, F) At 2 months after trauma, simple radiographs show volarly displaced distal radius fracture with volar tilt of 30°, 15° radial inclination, 5 mm ulnar positive variance. (G, H) Simple radiographs after open wedge osteotomy show a good alignment of distal radius with volar tilt of 10°, 23° radial inclination, 0 mm ulnar variance.

Table 1

The Preoperative and Postoperative Range of Motion and Grip Power

Table 2

Preoperative and Postoperative Radiological Values

Table 3

Mayo Wrist Score

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