scholarly journals Single-stage Distal Radius Dome Osteotomy with Ulnar Diaphyseal Shortening and Distal Ulnar Epiphysiodesis in A Case of Manus Valgus Deformity Secondary to Post-Traumatic Physeal Growth Arrest – A Case Report

2021 ◽  
Vol 11 (5) ◽  
Author(s):  
Aniruddha Sinha Sarkar ◽  
Ranadeb Bandyopadhyay ◽  
Pathikrit Guha Niyogi
Keyword(s):  
Case Report ◽  
Grip Strength ◽  
Distal Radius ◽  
Growth Arrest ◽  
Valgus Deformity ◽  
Left Wrist ◽  
Radial Inclination ◽  
Radial Deviation ◽  
Dome Osteotomy ◽  
Post Traumatic

Introduction: Distal radius physeal growth arrest in children secondary to trauma is a rare complication. Various modalities of surgical treatment exist. Correction of severe deformity by a single-stage surgery is rare in current literature. We describe a case of surgically treated post-traumatic manus valgus deformity in an adolescent female with a satisfactory surgical outcome. Case Report: A 13-year-old right-hand dominant girl presented to us with a painless, gradually progressive left wrist deformity for the past 3 years. She sustained a left wrist injury 3.5 years back for which she received native treatment. She was able to do most of her daily activities and cosmetic disability was her primary concern. She had a 20° fixed radial deviation deformity with further radial deviation up to 60°. Forearm rotation was from 70° supination to 60° pronation. Her pre-operative Mayo Modified Wrist Score was 25/10/10/25/70 (Pain/Satisfaction/Range of motion/Grip strength/Total). Radiologically, there was the obliteration of lateral distal radial physis with overgrowth of medial physis. Distal ulnar physeal overgrowth led to positive ulnar variance. Radiologically, the magnitude of deformity was 43° manus valgus (+24° radial inclination). We performed dome osteotomy at distal radius metaphysis with distal radius plating through modified Henry approach. Simultaneous ulnar diaphyseal shortening osteotomy with plate fixation was done through a dorsal approach and distal ulnar epiphysiodesis was done by physeal drilling to prevent future overgrowth. At 13 months follow-up, the wrist has clinically no deformity and radiologically 5° manus valgus (+24° radial inclination). Both the osteotomy sites have united and ulnar variance is restored. Now, her ulnar deviation was 20° and radial deviation was 30°. Her forearm rotational arc was maintained. Mayo Modified Wrist Score was 25/25/10/25/85 (Pain/Satisfaction/Range of motion/Grip strength/Total) with no hindrance of daily activity.

scholarly journals Reverse wedge osteotomy for Madelung’s deformity in a high school student: A case report

2021 ◽  
Vol 9 ◽  
pp. 2050313X2110498
Author(s):  
Tsuyoshi Tajika ◽  
Takuro Kuboi ◽  
Fumitaka Endo ◽  
Yuhei Hatori ◽  
Hirotaka Chikuda
Keyword(s):  
Case Report ◽  
Distal Radius ◽  
Joint Surface ◽  
Wedge Osteotomy ◽  
Growth Disturbance ◽  
Left Wrist ◽  
Ulnar Head ◽  
Madelung Deformity ◽  
Volar Aspect ◽  
Madelung’S Deformity

Madelung deformity is a congenital disorder with the malformation of anterior ulnar bowing of radius and a dorsally protruding ulnar head caused by premature growth disturbance at the medial volar aspect of the distal radius. This report describes a bilateral idiopathic Madelung deformity in a 17-year-old woman treated successfully using reverse wedge osteotomy of the distal radius in a symptomatic left wrist. Reverse wedge osteotomy can orient the radial joint surface while correcting the whole radius length by reversely putting the wedge bone removed from the distal metaphysis of radius, the base of which is cut from the surplus of the radial and dorsal cortical bone in the hypotrophic portion. We corrected the palmar subluxation of the carpus, restored her good function, and relieved her wrist pain.

Dual Plating Technique for Volar Rim Fracture of the Distal Radius Using DePuy-Synthes 2.0 m and 2.4 mm Locking Plates

2017 ◽  
Vol 22 (04) ◽  
pp. 423-428 ◽  
Author(s):  
Yoshihiro Abe ◽  
Masahiro Suzuki ◽  
Hiromasa Wakita
Keyword(s):  
Range Of Motion ◽  
Grip Strength ◽  
Distal Radius ◽  
Distal Radius Fractures ◽  
Ulnar Variance ◽  
Locking Plates ◽  
Radius Fractures ◽  
Radial Inclination ◽  
The Mean

Background: To assess the surgical results of distal radius fractures with the involvement of a volar rim fragment using the DePuy-Synthes 2.0 mm and 2.4 mm locking plates.Methods: Subjects were six women and one man of average age 57 years (range, 31–83 y) and a mean follow-up period of 9 months (range, 5–19 mo) with AO B3 (volar shearing) distal radius fractures. Time of the procedure, physical examination of wrist range of motion, grip strength compared with the contralateral healthy wrist, and radiographic evaluation (volar tilt, radial inclination, and ulnar variance) were evaluated. The Visual Analog Scale (VAS: 0 points represents no pain, 100 points represents the worst pain possible) and the Quick Disability of the Arm, Shoulder, and Hand questionnaire (QuickDASH, 0 = no disability, 100 = extreme disability) were completed by patients at the final follow-up.Results: The average time of the procedure was 74 min. There were no perioperative complications. Average radiographic measures were: volar tilt, 8°; radial inclination, 23°, and ulnar variance, 0 mm. Wrist range of motion averaged 63° in wrist extension (range, 55–80°) and 55° in wrist flexion (range, 45–65°). Grip strength averaged 81% of the contralateral side at final evaluation (range, 67–100%). The mean QuickDASH score was 3.0 points (range, 0–9.1 points) and the mean VAS for pain was 9.3 at final follow-up.Conclusions: Open reduction internal fixation with the DePuy-Synthes 2.0 mm and 2.4 mm locking plates is an effective means of fixing a distal radius fracture that includes a volar rim fragment without interfering with flexor tendon gliding.

scholarly journals The relationship between radiological alignment of united distal radius fractures and functional and patient-perceived outcomes in elderly patients

2017 ◽  
Vol 25 (1) ◽  
pp. 230949901668497 ◽  
Author(s):  
Erik Hohmann ◽  
Mahendrakumar Meta ◽  
Vasudev Navalgund ◽  
Kevin Tetsworth
Keyword(s):  
Elderly Patients ◽  
Grip Strength ◽  
Distal Radius ◽  
Distal Radius Fractures ◽  
Ulnar Variance ◽  
Pinch Strength ◽  
Radius Fractures ◽  
Radial Inclination ◽  
Perceived Outcomes ◽  
The Relationship

Purpose: The purpose of this study was to investigate the relationship between radiological alignment and functional outcomes including strength, range of motion (ROM), and disabilities of the arm, shoulder, and hand (DASH) and patient-rated wrist evaluation (PRWE) scores in elderly patients with united distal radius fractures. Methods: We reviewed 118 patients (mean age of 76.2 ± 9.5 years, mean follow-up 36.3 ± 17.6 months). Outcome measures included the DASH and PRWE scores, ROM, and grip and pinch strength were measured using a validated mobile hand-held dynamometer. Radial height, radial inclination, ulnar variance, and palmar tilt were measured on standard radiographs. Results: The mean total score for DASH was 4.9 ± 7.4 and 6.9 ± 11 for the PRWE. There were significant differences in ROM for palmar flexion and ulnar deviation between the affected wrist and the normal wrist. Linear regression revealed significant relationships for the following variables: between DASH and radiological palmar tilt, between PRWE and radiological palmar tilt, between grip strength and radial inclination, between grip strength and radial height, and between grip strength and ulnar variance. Conclusion: This study suggests that minor deformities of the distal radius following distal radius fractures treated with either operative or nonoperative treatment are unlikely to be clinically relevant and have no impact on patient perceived outcomes for elderly patients.

scholarly journals Primary Fixation of AO Type-C Fracture of the Distal Radius with Volar Locking Plates. A Cross-Sectional Study of Patient Rated Outcomes at Hospital Tengku Ampuan Afzan

2020 ◽  
Vol 13 (2) ◽  
Author(s):  
Mohd Sallehuddin H ◽  
Zamzuri Z ◽  
Ariff MS ◽  
Mohd Shukrimi A ◽  
Mohamed Azril MA ◽  
...  
Keyword(s):  
Grip Strength ◽  
Distal Radius ◽  
Functional Outcomes ◽  
Cross Sectional Study ◽  
Dash Score ◽  
Sectional Study ◽  
Cross Sectional ◽  
Radial Inclination ◽  
Type C ◽  
One Year

Introduction: This is a cross-sectional study of 37 patients with AO type C (complete intra-articular) fractures of the distal radius, evaluating the functional, anatomical, and patient rated outcomes one year after primary fixation with a volar locking plate. Methods: Functional outcomes were assessed based on the grip strength, and the range of motion of forearm and wrist. Anatomical outcomes were assessed based on the radial inclination, radial height, volar tilt, and articular step or gap. Patient rated outcome was measured with a Disability of arm, shoulder and hand (DASH) questionnaire. Results: One year after surgery, 24 (64%) patients achieved good and excellent anatomical results, and DASH scores were acceptable in 73% of patients. Most of the patients had achieved 80% of their grip strength. The mean DASH score of 12.3 was comparable with other studies. Grip strength, radial inclination and volar tilt had a significant correlation with the DASH score. Conclusion: Volar locking plates can be used to achieve optimal reduction in all three parameters in the treatment of AO type C fractures of the distal radius. Versatile fracture fragment reduction and angular stability enable rehabilitation hence obtaining good functional outcomes.

scholarly journals Two-stage treatment of a growth arrest of the distal radius—a case report

2004 ◽  
Vol 75 (6) ◽  
pp. 775-778
Author(s):  
Guy Dagregorio ◽  
Yann Saint-Cast
Keyword(s):  
Case Report ◽  
Distal Radius ◽  
Growth Arrest ◽  
Two Stage

Two-stage treatment of a growth arrest of the distal radius - a case report

2004 ◽  
Vol 75 (6) ◽  
pp. 1-1
Author(s):  
Guy Dagregorio ◽  
Yann Saint-Cast
Keyword(s):  
Case Report ◽  
Distal Radius ◽  
Growth Arrest ◽  
Two Stage

Corrective Osteotomies after Injuries of the Distal Radial Physis in Children

1997 ◽  
Vol 22 (6) ◽  
pp. 699-704 ◽  
Author(s):  
L. M. HOVE ◽  
L. B. ENGESÆTER
Keyword(s):  
Postoperative Pain ◽  
Pain Relief ◽  
Range Of Motion ◽  
Distal Radius ◽  
Iliac Crest ◽  
Distal Forearm ◽  
Growth Disturbance ◽  
Radial Inclination ◽  
Lengthening Osteotomy ◽  
Post Traumatic

Six children had corrective osteotomies of the distal forearm because of growth disturbance from post-traumatic closure of the distal radial physis. Lengthening osteotomy of the radius was performed in three patients with grafts from the iliac crest. All osteotomies healed in a satisfactory position. Three patients had only moderate mal-angulation of the radius and were treated by shortening of the ulna. The median postoperative palmar angulation of the distal radius was 4 (0–13)°, the radial inclination 22 (15–28)°, and the ulnar variance was –2 (–4 – +2) mm. The postoperative pain relief was complete in all patients and the total range of motion was 96 (93–100)% compared with the opposite side.

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