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Retrospective study of radial dome osteotomy with volar plate fixation versus K-wires in Madelung’s deformity: long-term follow-up

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Abstract

Purpose

The emerging role of the locking plate improved the technique also in corrective osteotomies in Madelung’s deformity, but there is a lack of analyses between the fixation techniques, as well as little information in functional outcomes and long-term follow-up. The current study compared the outcomes, pitfalls, and advantages of volar plate and screws fixation versus K-wires fixation in a long-term follow-up.

Methods

Twenty-eight children presenting the “distal radius” variant of Madelung’s deformity underwent Vickers ligament release and distal radial dome osteotomy between 2009 and 2015. Twenty-three children (20 females and 3 males, mean age 15 years and 7 months at surgery and 24 years and 8 moths at follow-up), with 26 operatively treated wrists, were available for follow-up. A retrospective two-cohort study, evaluating clinically and radiologically results, has been conducted with a mean eight years and seven months follow-up.

Results

Bone union and pain relief were obtained in all cases, as well as improvements in wrist motion and radiographic indices. A statistically significant correlation was identified between the volar plate fixation and an improved lunate subsidence on X-ray, and a trend towards an improved DASH score in the cohort with plate and screws, as well as significant improvement in wrist extension and supination always in the plate fixation cohort.

Conclusions

The long-term follow-up enabled the patients to report on more definitive outcomes in terms of functional and cosmetic improvements. Volar plate fixation is an effective technique allowing for simple post-operative management and earlier rehabilitation program with improved clinical and radiographic outcomes.

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Availability of data and materials

All materials and data are recorded in the Gestional Control Service of the Institute according to the functional and instrumental records of the patients.

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Author information

Authors and Affiliations

  1. Department of Hand Surgery and Microsurgery, AOU Policlinico, L.go del Pozzo, 71, 41124, Modena, Italy

    Andrea Leti Acciaro, Mario Lando & Roberto Adani

  2. Hand Unit/Department of Orthopaedics, Guy’s and St Thomas’ NHS Foundation Trust, London, UK

    Lorenzo Garagnani

  3. Department of Orthopaedic and Traumatology, University of Modena and Reggio Emilia, AOU Policlinico, Modena, Italy

    Giacomo Cataldo

Authors
  1. Andrea Leti Acciaro
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  2. Lorenzo Garagnani
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  3. Mario Lando
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  4. Giacomo Cataldo
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  5. Roberto Adani
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Contributions

All authors contributed to the study conception and design, as well as material preparation, data collection and analysis, and first draft of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Andrea Leti Acciaro.

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Ethical approval

This is an observational retrospective study; no ethical approval is required by local Research Ethics Committee.

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Informed consent was obtained from all individual participants, or parents, included in the study, both for surgical technique and follow-up.

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Patients signed informed consent regarding recording or publishing their photographs and data. However, no personal or identifying information are included in this article.

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The authors declare no competing interests.

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Leti Acciaro, A., Garagnani, L., Lando, M. et al. Retrospective study of radial dome osteotomy with volar plate fixation versus K-wires in Madelung’s deformity: long-term follow-up. International Orthopaedics (SICOT) 46, 281–289 (2022). https://doi.org/10.1007/s00264-021-05266-0

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  • DOI: https://doi.org/10.1007/s00264-021-05266-0

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