Document Detail


Recurrence of radial bowing after soft tissue distraction and subsequent radialization for radial longitudinal deficiency.
MedLine Citation:
PMID:  23021174     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
PURPOSE: Centralization and radialization are the most widely reported surgical treatments for Bayne and Klug Type III and IV radial longitudinal deficiency. Prior soft tissue distraction has been introduced to improve reducibility of the deformity without skeletal resection. Satisfying long-term effects have been reported with centralization but are still unclear with radialization.
METHODS: This is a retrospective study of 8 consecutive children with Bayne and Klug Type III or IV radial longitudinal deficiency treated with preliminary soft tissue distraction followed by radialization between 2003 and 2008. All children underwent the same surgical protocol. End points of the study were clinical appearance, the hand-forearm angle, and mean angular correction at last follow-up.
RESULTS: The mean preoperative hand-forearm angle was 61° (26°-91°). The average duration of distraction was 1.9 month (1-3 mo). The initial postoperative angle averaged 12° (-14°-40°). There were 3 postoperative complications: 2 cases of pin loosening and 1 case of fracture of the base of the small finger metacarpal. Mean follow-up duration was 2.6 years (1-4 y). At last follow-up, 7 of the 8 patients had visible recurrence of the deformity, the hand-forearm angle had deteriorated to 44° (20°-69°), and the mean angular correction was 18° (-43°-59°).
CONCLUSIONS: Preoperative distraction allows a gradual realignment of the hand on the forearm without skeletal resection, but the recurrence rate after radialization is high. Tendon transfers and soft tissue tensioning were unable to maintain hand-forearm alignment following soft tissue distraction.
TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV.
Authors:
Caroline Dana; Jean-Charles Aurégan; Arielle Salon; Stéphane Guéro; Christophe Glorion; Stéphanie Pannier
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of hand surgery     Volume:  37     ISSN:  1531-6564     ISO Abbreviation:  J Hand Surg Am     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-10-01     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7609631     Medline TA:  J Hand Surg Am     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2082-7     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.
Affiliation:
Necker-Enfants Malades Hospital, Department of Pediatric Orthopedics, University Paris Descartes, Paris, France.
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