| Distal radius osteotomy in the elderly patient using angular stable implants and Norian bone cement. | |
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MedLine Citation:
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PMID: 17826549 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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PURPOSE: To report our results after testing the combination of two technologies--angular-stable locking screw implants and Norian SRS cement--in corrective osteotomies of the distal radius in the elderly. This technique eliminates donor site bone-graft morbidity and expands the indications of corrective osteotomies to older patients with osteoporotic bone. METHODS: Our retrospective series include 6 patients (5 women and 1 man) with an average age of 60 years. Three patients had corrections through a dorsal approach, 1 through a volar approach, and 2 through a combined approach. Two corrections included an intraarticular osteotomy. We used 2.4-mm volar T plates in patients approached volarly and 2.4-mm L and T plates for those approached dorsally; the osseous defect was filled with bone cement (Norian SRS). Range of motion and grip strength were measured at 16 months average follow-up. Standard wrist radiographs were taken to evaluate alignment and determine improvement. At final follow-up, patients completed the Modified Mayo Wrist score, the Modified Gartland and Werley score, and the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire. RESULTS: There were no perioperative complications. All corrective osteotomies healed. One patient required a Darrach procedure at 6 months. The average wrist and forearm motion was 77% of the opposite side and grip strength 88% of the opposite side. The average total correction in the sagittal plane was 22 degrees with all patients returning to neutral or better alignment. The average ulnar variance improvement was 2 mm. Average postoperative DASH was 28 points; average Modified Mayo Wrist score was 68; and the Modified Gartland and Werley score averaged 9 points. CONCLUSIONS: We believe that corrective osteotomy of the distal radius in the elderly using angular stable implants and Norian calcium phosphate cement is a safe and predictable surgical technique, even in patients with underlying osteoporosis. It eliminates donor site morbidity, and patient-rated outcome measures demonstrated acceptable daily living function return. |
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Authors:
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Santiago Lozano-Calderón; Michael Moore; Matthew Liebman; Jesse B Jupiter |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: The Journal of hand surgery Volume: 32 ISSN: 0363-5023 ISO Abbreviation: J Hand Surg Am Publication Date: 2007 Sep |
Date Detail:
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Created Date: 2007-09-10 Completed Date: 2007-12-14 Revised Date: 2009-06-08 |
Medline Journal Info:
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Nlm Unique ID: 7609631 Medline TA: J Hand Surg Am Country: United States |
Other Details:
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Languages: eng Pagination: 976-83 Citation Subset: IM |
Affiliation:
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Hand and Upper Extremity Service, Department of Orthopaedic Surgery, Massachusetts General Hospital-Harvard Medical School, Boston, MA 02114, USA. slozanocalderon@partners.org |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Bone Cements / therapeutic use* Bone Plates* Calcium Phosphates / therapeutic use* Disability Evaluation Female Follow-Up Studies Fractures, Malunited / surgery* Hand Strength Humans Male Middle Aged Osteotomy / methods* Radius / surgery* Radius Fractures / surgery Range of Motion, Articular Retrospective Studies Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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0/Bone Cements; 0/Calcium Phosphates |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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