桡骨远端畸形愈合联合尺侧截骨术。

IF 1 4区医学 Q4 ORTHOPEDICS

Hand Surgery & Rehabilitation Pub Date : 2025-09-01 DOI:10.1016/j.hansur.2025.102207

Arnaud Walch , Sabine Pillot , Thais Galissard , Aram Gazarian , Thibault Druel

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引用次数: 0

摘要

目的：桡骨远端畸形愈合改变手腕生物力学，导致疼痛、僵硬和功能损害。存在多种矫正截骨技术。本研究的目的是评估桡骨闭合楔形截骨术和尺骨缩短截骨术联合治疗桡骨远端畸形愈合的功能结果。材料和方法：我们回顾性分析了20例桡骨远端畸形连行桡骨闭合楔形截骨联合尺侧截骨术的患者。分析功能结果、握力、活动范围和影像学参数。结果：手术显著改善了旋后（20°至80°）、屈曲（40°至60°）、伸展（50°至65°）和握力（12 kg至22 kg）。完成尺方差校正。4例出现并发症，其中3例需要翻修手术。讨论：桡侧闭合楔形截骨联合尺侧缩短截骨可有效恢复腕关节功能，同时避免移植物相关并发症。该入路为桡骨远端畸形愈合提供了一种开放楔形截骨术的替代方法。证据等级：四级。

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Combined radial closing-wedge osteotomy and ulnar shortening osteotomy for distal radius malunion

Purpose

Distal radius malunion alters wrist biomechanics, leading to pain, stiffness, and functional impairment. Various corrective osteotomy techniques exist. The aim of this study was to evaluate the functional outcomes of a combined radial closing-wedge osteotomy and ulnar shortening osteotomy in the treatment of distal radius malunions.

Materials and Methods

We retrospectively reviewed 20 patients who underwent combined radial closing-wedge osteotomy and ulnar shortening osteotomy for symptomatic distal radius malunions. Functional outcomes, grip strength, range of motion, and radiographic parameters were analyzed.

Results

Surgery significantly improved supination (20°–80°), flexion (40°–60°), extension (50°–65°), and grip strength (12 kg–22 kg). Ulnar variance correction was achieved. Complications occurred in four cases, with three requiring revision surgery.

Discussion

Combined radial closing-wedge osteotomy and ulnar shortening osteotomy effectively restores wrist function while avoiding graft-related complications. This approach provides an alternative to opening-wedge osteotomies for distal radius malunions.

Level of Evidence

IV.

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来源期刊

Hand Surgery & Rehabilitation Medicine-Surgery

CiteScore

1.70

自引率

27.30%

发文量

审稿时长

49 days

期刊介绍： As the official publication of the French, Belgian and Swiss Societies for Surgery of the Hand, as well as of the French Society of Rehabilitation of the Hand & Upper Limb, ''Hand Surgery and Rehabilitation'' - formerly named "Chirurgie de la Main" - publishes original articles, literature reviews, technical notes, and clinical cases. It is indexed in the main international databases (including Medline). Initially a platform for French-speaking hand surgeons, the journal will now publish its articles in English to disseminate its author''s scientific findings more widely. The journal also includes a biannual supplement in French, the monograph of the French Society for Surgery of the Hand, where comprehensive reviews in the fields of hand, peripheral nerve and upper limb surgery are presented. Organe officiel de la Société française de chirurgie de la main, de la Société française de Rééducation de la main (SFRM-GEMMSOR), de la Société suisse de chirurgie de la main et du Belgian Hand Group, indexée dans les grandes bases de données internationales (Medline, Embase, Pascal, Scopus), Hand Surgery and Rehabilitation - anciennement titrée Chirurgie de la main - publie des articles originaux, des revues de la littérature, des notes techniques, des cas clinique. Initialement plateforme d''expression francophone de la spécialité, la revue s''oriente désormais vers l''anglais pour devenir une référence scientifique et de formation de la spécialité en France et en Europe. Avec 6 publications en anglais par an, la revue comprend également un supplément biannuel, la monographie du GEM, où sont présentées en français, des mises au point complètes dans les domaines de la chirurgie de la main, des nerfs périphériques et du membre supérieur.