Extra-articular distal radius malunion: The phosphate cement alternative - 25/08/10

Doi : 10.1016/j.otsr.2010.03.018

L. Obert ^a, D. Lepage ^a, N. Gasse ^a,^⁎ , S. Rochet ^a, P. Garbuio ^a
^a Orthopedics, Traumatology Plastic and Reconstructive Hand Surgery Dept, Surgical Innovation and Technique Center, EA 4268 Innovation, Imaging, Engineering and Intervention in Health, IFR 133 Inserm, Jean-Minjoz University Hospital, Franche-Comté University, Besançon, France

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Summary

Five consecutive patients (mean age: 40.4 yrs (range, 19–58 yrs)), with symptomatic distal radius malunion underwent corrective opening wedge osteotomy using phosphate cement as an alternative to bone autograft, at a mean 9 months (4–16mo) of fracture. Internal fixation used a plate placed just above the distal radioulnar joint, with soft-tissue release. Radiographic and functional parameters were measured before surgery, and at 6 months and 1 year. At a mean 32.4 months (range, 16–47mo), all patients were satisfied and all the osteotomies were united. At 1 year’s follow-up, wrist range of motion reached 75% compared to the contralateral side. Two biopsies performed during plate removal showed osteoid tissue at the cement–bone junction. It is reasonable to consider injectable phosphate cement as a viable alternative to bone grafting in conjunction with surgical correction of distal radius malunion.

Level of evidence: level IV.

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Keywords : Malunion, Distal radius, Osteotomy, Calcium phosphate cements, Bone substitutes