Purpose
To evaluate gradual distraction lengthening or distraction osteogenesis as a technique
for treating malunions of the distal radius.
Methods
Twenty patients with clinical and radiographic evidence of distal radius malunion
were treated with osteotomy of the distal radius using distraction osteogenesis. At
the follow-up evaluation each patient was evaluated for healing rates, complications,
resolution of pain, and radiographic alignment. Surgical treatment consisted of an
application of a nonbridging external fixator that could be distracted to correct
the deformity. A loosely set screw that connected the distal pins to the fixator served
as a hinge and allowed the distal radius to rotate into a corrected position. Gradual
distraction via distraction osteogenesis was initiated 1 week after surgery.
Results
Seventeen osteotomies healed uneventfully in an average of 9 weeks. Complications
included 9 pin track infections. Two nonunions required bone grafting. One patient
inadvertently compressed rather than distracted the fixator, leading to premature
healing of the osteotomy. One patient ruptured the extensor pollicis longus. All complications
resolved with additional intervention. Overall the patients showed radiographic and
symptomatic improvement.
Conclusions
An external fixator and distraction lengthening through distraction osteogenesis is
a viable alternative to plate fixation and bone grafting. In 18 of 20 of our patients,
the technique eliminated the need for bone grafting and the need for a second surgical
procedure to remove a dorsal plate.
Type of study/level of evidence
Therapeutic IV.
Key words
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Article info
Publication history
Accepted:
February 12,
2007
Received:
February 6,
2007
Footnotes
No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.
Identification
Copyright
© 2007 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.
