Document Detail

External fixation and centralization versus external fixation and ulnar osteotomy: the treatment of radial dysplasia using the resolved total angle of deformity.
MedLine Citation:
PMID:  20104165     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The purpose of this study is to compare preliminary external fixation and centralization to ulnar osteotomy with external fixation for the treatment of radial dysplasia as measured by the resolved total angle (RTA) of deformity. METHODS: This is a retrospective review of 11 patients (14 limbs) with radial dysplasia. The 3-dimensional deformity was measured by the RTA. Six patients (8 limbs, group 1) underwent correction of their angular deformity with preliminary external fixator distraction followed by centralization. Five patients (6 limbs, group 2) underwent ulnar osteotomy with external fixation. Mean age was 9 years, with a mean follow-up of 41 months. RESULTS: Initial RTA was 112 degrees for group 1, which improved to 38 degrees postoperatively, but worsened to 71 degrees at follow-up. In group 2 the initial RTA was 88 degrees, which improved to 50 degrees, with a worsening to 95 degrees at follow-up. The RTA was found to have high interrater and intrarater reliability. CONCLUSIONS: The RTA defines the maximum deformity in radial dysplasia and is a reliable measure. Using the RTA, we showed that preliminary external fixation and centralization are more effective than ulnar osteotomy with external fixation, but both have a high recurrence rate. LEVEL OF EVIDENCE: III.
James J McCarthy; Scott H Kozin; Christopher Tuohy; Emilie Cheung; Richard S Davidson; Kenneth Noonan
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of pediatric orthopedics     Volume:  29     ISSN:  1539-2570     ISO Abbreviation:  J Pediatr Orthop     Publication Date:    2009 Oct-Nov
Date Detail:
Created Date:  2010-01-27     Completed Date:  2010-05-18     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8109053     Medline TA:  J Pediatr Orthop     Country:  United States    
Other Details:
Languages:  eng     Pagination:  797-803     Citation Subset:  IM    
American Family Children's Hospital, Madison, WI, USA.
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MeSH Terms
Bone Diseases, Developmental / pathology,  surgery*
Child, Preschool
External Fixators
Follow-Up Studies
Osteotomy / methods*
Radius / abnormalities*,  radiography,  surgery*
Retrospective Studies
Treatment Outcome
Ulna / surgery*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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