Purpose
To compare patient-reported outcomes, functional outcomes, radiographic alignment,
and complications of volar versus dorsal corrective osteotomies as the treatment for
symptomatic distal radius malunions.
Methods
We performed a retrospective review of all patients who underwent a distal radius
corrective osteotomy with either a volar or dorsal approach and plating at 1 of 3
institutions between 2005 and 2017. Demographic data, type of surgical treatment,
and radiographs were examined. Outcomes were Quick–Disabilities of the Arm, Shoulder,
and Hand (QuickDASH) function scores and radius union scoring system as well as major and minor complications.
Results
We included 53 cases (37 volar osteotomies and 16 dorsal osteotomies). Postoperative
follow-up from the time of surgery to last QuickDASH score was 84.6 months (range, 12–169.4 months). Compared with the dorsal osteotomy
group, the volar osteotomy group demonstrated a better postoperative flexion-extension
arc (94.9° vs 72.9°, respectively), pronation-supination arc (146.2° vs 124.9°, respectively),
and last QuickDASH scores (6.65 vs 12.87), respectively. Radiographically, there was no difference
noted in radial height, radial inclination, or volar tilt in the immediate postoperative
and last radiographs. There was a higher rate of complications in the dorsal osteotomy
group (8 cases [50% of patients]) compared with the volar osteotomy group (7 cases
[18.9% of patients]), including a higher rate of hardware removal.
Conclusions
For patients with symptomatic malunions of the distal radius, the volar and dorsal
approaches both resulted in improvement in QuickDASH scores and range of motion. Volar plating resulted in slightly better QuickDASH scores and fewer complications compared with dorsal plating.
Type of study/level of evidence
Therapeutic IV.
Key words
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Article info
Publication history
Published online: August 14, 2019
Accepted:
May 10,
2019
Received:
October 23,
2018
Footnotes
No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.
Identification
Copyright
© 2020 by the American Society for Surgery of the Hand. All rights reserved.
