J Wrist Surg 2020; 09(02): 136-140
DOI: 10.1055/s-0039-3402082
Scientific Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Functional Outcomes after Corrective Osteotomy of Symptomatic Distal Radius Malunions in Children

C. A. Selles
1   Department of Trauma, Maasstad Hospital, Rotterdam, The Netherlands
2   Department of Hand Surgery, Maasstad Hospital, Rotterdam, The Netherlands
,
M. A. M. Mulders
1   Department of Trauma, Maasstad Hospital, Rotterdam, The Netherlands
,
G. R. Roukema
1   Department of Trauma, Maasstad Hospital, Rotterdam, The Netherlands
,
C. H. van der Vlies
1   Department of Trauma, Maasstad Hospital, Rotterdam, The Netherlands
,
B. I. Cleffken
1   Department of Trauma, Maasstad Hospital, Rotterdam, The Netherlands
2   Department of Hand Surgery, Maasstad Hospital, Rotterdam, The Netherlands
,
M. H. J. Verhofstad
3   Trauma Research Unit, Department of Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands
,
N. W. L. Schep
1   Department of Trauma, Maasstad Hospital, Rotterdam, The Netherlands
2   Department of Hand Surgery, Maasstad Hospital, Rotterdam, The Netherlands
› Author Affiliations
Funding None.
Further Information

Publication History

22 August 2019

13 November 2019

Publication Date:
30 December 2019 (online)

Abstract

Background Closed reduction and cast immobilization of displaced distal radius fractures carries the risk of secondary displacement, which could result in a symptomatic malunion. In patients with a symptomatic malunion, a corrective osteotomy can be performed to improve pain and functional impairment of the wrist joint.

Objective The aim of this study was to assess the functional outcomes of children who underwent a corrective osteotomy due to a symptomatic malunion of the distal radius.

Methods Between 2009 and 2016, all consecutive corrective osteotomies of the distal radius of patients younger than 18 years were reviewed. The primary outcome was functional outcome assessed with the ABILHAND-Kids score. Secondary outcomes were QuickDASH (Quick Disabilities of Arm, Shoulder, and Hand) score, range of motion, complications, and radiological outcomes.

Results A total of 13 patients with a median age of 13 years (interquartile range [IQR]: 12.5–16) were included. The median time to follow-up was 31 months (IQR: 26–51). The median ABILHAND-Kids score was 42 (range: 37–42), and the median QuickDASH was 0 (range: 0–39). Range of motion did not differ significantly between the injured and the uninjured sides for all parameters. One patient had a nonunion requiring additional operative treatment. The postoperative radiological parameters showed an improvement of radial inclination, radial height, ulnar variance, dorsal tilt, and dorsal tilt.

Conclusion Corrective osteotomy for children is an effective method for treating symptomatic malunions of the distal radius.

Level of Evidence This is a Level IV study.

Note

This work was performed in the Maasstad Hospital.


 
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