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Nascent Malunion of Distal Radius Fractures Treated with Fixed Angled Volar Plates without Using Bone Grafts

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Abstract

Purpose

Malunion of the distal radius is a common complication. Using bone grafts is common to restore the bone to an acceptable level. This study aimed to verify if it is necessary to use bone grafts in nascent malunion of distal radius fractures treated with fixed angled volar plates and which radiographic parameters are essential to obtain satisfactory outcomes.

Methods

This single-centered prospective study included 11 patients who underwent corrective osteotomy of the radius for malunion. Patients with a metaphyseal, extraarticular osteotomy stabilized by a volar fixed angle plate within 3 months after the fracture are included. Patients underwent a standard radiological evaluation at postoperative 1 month, 3 months, 6 months, 1 year, and annually thereafter. Radial inclination, radial height, ulnar variance, and palmar tilt were measured. Wrist ranges of motion are measured throughout follow-up with a goniometer. Grip strength is measured using a Jamar Hand Dynamometer. The function is evaluated via the Gartland–Werley (GW) score and the Disabilities of the Arm, Shoulder, and Hand (DASH) score.

Results

The mean age of 11 patients, 9 (81.82%) males, included in the study was 41.45 ± 14.89 years. The mean post-fracture admission time is 39.3 ± 15.1 days. Radial inclination, radial length, and ulnar variance improved significantly after surgery (p = 0.0023, 0.0002, 0.0037). Radial inclination values are within normal limits for all patients at admission. The radial length was in the normal range for 72.73%, the ulnar variance was in the normal range for 72.73%, and palmar tilt was in the normal range for 100% of the patients. Extension 54.55%, flexion 72.73%, radial deviation 81.82%, ulnar deviation 63.64%, pronation 90.91%, and supination 72.73% were achieved after surgery. GW average was 3.09 ± 3.24 DASH score average was 12.24 ± 13.48. The mean grip strength was 29.27 ± 7.21 on the operated side, while it was 34.91 ± 5.32, on the healthy side, with a significant difference (p = 0.0108).

Conclusion

It is possible to get good results without using bone grafts in corrective osteotomy of distal radius malunions.

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Acknowledgements

We did not receive any contributions from anyone.

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We have no financial biases.

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Authors and Affiliations

  1. Faculty of Medicine, Orthopedics and Traumatology Department, Ibn’i Sina Hospital, Ankara University, Hand Surgery Unit, Sıhhiye/ANKARA TR, Ankara, Turkey

    Uğur Bezirgan & Yener Yoğun

  2. Orthopedics and Traumatology Department, Ankara City Hospital, Hand Surgery Unit, Ankara, Turkey

    Erdinç Acar

  3. Faculty of Medicine, Orthopedics and Traumatology Department, Ankara University, Ankara, Turkey

    Merve Dursun Savran

  4. Orthopedics and Traumatology Department, Ankara City Hospital, Ankara, Turkey

    Ömer Halit Keskin

  5. Faculty of Medicine, Orthopedics and Traumatology Department, Ankara University, Hand Surgery Unit, Ankara, Turkey

    Mehmet Armangil

Authors
  1. Uğur Bezirgan
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  2. Erdinç Acar
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  3. Yener Yoğun
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  4. Merve Dursun Savran
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  5. Ömer Halit Keskin
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  6. Mehmet Armangil
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Contributions

UB Performed operations, wrote the paper. EA Conceived and design the analysis. YY Wrote the paper, collected the data. MDS Contributed data or analysis tools, ÖHK Collected the data, MA Performed operations, wrote the paper.

Corresponding author

Correspondence to Yener Yoğun.

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All authors have no potential conflicts of interest, including financial interests, activities, relationships, and affiliations, to disclose.

Ethical approval

This study was reviewed and approved by the Local Ethics Committee (20–691).

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Informed consent was obtained from all individual participants included in the study.

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Bezirgan, U., Acar, E., Yoğun, Y. et al. Nascent Malunion of Distal Radius Fractures Treated with Fixed Angled Volar Plates without Using Bone Grafts. JOIO 57, 533–542 (2023). https://doi.org/10.1007/s43465-023-00864-z

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  • DOI: https://doi.org/10.1007/s43465-023-00864-z

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