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HAND
Published in: HAND 3/2014

Open Access 01-09-2014 | Review

Reconstruction of malunited diaphyseal fractures of the forearm

Authors: Prakash Jayakumar, Jesse B Jupiter

Published in: HAND | Issue 3/2014

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Abstract

The forearm is a complex anatomical and functional unit with unique osseous, soft tissue and articular relationships. Disruption of these important relations can have a significant impact, leading to pain, instability of the radio-ulnar articulation and reduced range of motion. The gold standard for treating forearm fractures in adults remains anatomic reduction, stable plate fixation and preservation of the surrounding blood supply. Failure to achieve these goals may lead to malunion, requiring reconstructive surgery, which can be technically challenging. In this review, we discuss the essential aspects of anatomy and pathomechanics, clinical and radiological assessment and the state of the art in pre-operative planning and deformity correction surgery.
Literature
1.
Anderson LD, Sisk D, Tooms RE, et al. Compression-plate fixation in acute diaphyseal fractures of the radius and ulna. J Bone Joint Surg. 1975;57(3):287–97.PubMed
2.
Bindra RR, Cole RJ, Yamaguchi K, et al. Quantification of the radial torsion angle with computerized tomography in cadaver specimens. J Bone Joint Surg Am. 1997;79:833–7.PubMed
3.
Blackburn N, Ziv I, Rang M. Correction of the malunited forearm fracture. Clin Orthop Relat Res. 1984;188:54–7.PubMed
4.
Blount WP. Tibia vara: osteochondrosis deformans tibiae. J Bone Joint Surg. 1937;19:1–29. Boston.
5.
Bowers WH. Instability of the distal radioulnar articulation. Hand Clin. 1991;7:311–27.PubMed
6.
Burwell HN, Charnley AD. Treatment of forearm fractures in adults with particular reference to plate fixation. J Bone Joint Surg (Br). 1964;46:404–25.
7.
Chapman MW, Gordon JE, Zissimos AG. Compression plate fixation of acute fractures of the diaphyses of the radius and ulna. J Bone Joint Surg Am. 1989;71(2):159–69.PubMed
8.
Cooper RR. Management of common forearm fractures in children. J Iowa Med Soc. 1964;54:689–98.PubMed
9.
Crisco JJ, Moore DC, Marai GE, et al. Effects of distal radius malunion on distal radioulnar joint mechanics: an in vivo study. J Orthop Res. 2007;25:547–55.PubMedCrossRef
10.
Dodge HS, Cady GW. Treatment of fractures of the radius and ulna with compression plates. J Bone Joint Surg Am. 1972;54(6):1167–76.PubMed
11.
Dumont CE, Thalmann R, Macy JC. The effect of rotational malunion of the radius and the ulna on supination and pronation. J Bone Joint Surg (Br). 2002;84:1070–4.CrossRef
12.
Dumont CE, Pfirrmann CWA, Ziegler D, et al. Assessment of radial and ulnar torsion profiles with cross-sectional magnetic resonance imaging: a study of volunteers. J Bone Joint Surg Am. 2006;88:1582–8.PubMedCrossRef
13.
Dumont CE, Nagy L, Ziegler D, et al. Fluoroscopic and magnetic resonance cross-sectional imaging assessments of radial and ulnar torsion profiles in volunteers. J Hand Surg [Am]. 2007;32:501–9.CrossRef
14.
Evans EM. Rotational deformities in the treatment of fractures of both bones of the forearm. J Bone Joint Surg. 1945;27(3):373–9.
15.
Freedman L, Luk K, Leong JC. Radial head reduction after a missed Monteggia fracture: brief report. J Bone Joint Surg (Br). 1988;70:846–7.
16.
Fuller DJ, McCullough CJ. Malunited fractures of the forearm in children. J Bone Joint Surg (Br). 1982;64:364–7.
17.
Furnstahl P, Schweizer A, Nagy L, et al. A morphological approach to the simulation of forearm motion. Conf Proc IEEE Eng Med Biol Soc. 2009;2009:7168–71.PubMed
18.
Goldfarb CA, Ricci WM, Tull F, et al. Functional outcome after fracture of both bones of the forearm. J Bone Joint Surg (Br). 2005;87(3):374–9.CrossRef
19.
Graham TJ, Fischer TJ, Hotchkiss RN, et al. Disorders of the forearm axis. Hand Clin. 1998;14:305–16.PubMed
20.
Hasler CC, Von Laer L, Hell AK. Open reduction, ulnar osteotomy and external fixation for chronic anterior dislocation of the head of the radius. J Bone Joint Surg (Br). 2005;87:88–94.
21.
Henry AK. Extensile exposure applied to limb surgery. Edinburgh: Livingstone; 1945. p. 59–65.
22.
Hotchkiss RN, An KN, Sowa DT, et al. An anatomic and mechanical study of the interosseous membrane of the forearm: pathomechanics of proximal migration of the radius. J Hand Surg [Am]. 1989;14:256–61.CrossRef
23.
Hughston JC. Fracture of the forearm in children. J Bone Joint Surg Am. 1962;44:1678–93.
24.
Ishii T, Ikeda M, Kobayashi Y et al. Flexor digitorum profundus tendon rupture associated with distal radius fracture malunion: a case report. 2009; 14(1): 35-8.
25.
Jupiter JB, Fernandez DL, Levin LS, et al. Reconstruction of posttraumatic disorders of the forearm. Instr Course Lect. 2010;59:283–93.PubMed
26.
Kasten P, Krefft M, Hesselbach J, et al. How does torsional deformity of the radial shaft influence the rotation of the forearm? A biomechanical study. J Orthop Trauma. 2003;17:57–60.PubMedCrossRef
27.
Kataoka T, Oka K, Miyake J, et al. 3-Dimensional prebent plate fixation in corrective osteotomy of malunited upper extremity fractures using a real-sized plastic bone model prepared by preoperative computer simulation. J Hand Surg. 2013;38(5):909–19.CrossRef
28.
Leong N, Buijke G, Fu E, et al. Computer-assisted versus non-computer-assisted preoperative planning of corrective osteotomy for extra-articular distal radius malunions: a randomized controlled trial. 2010;11:282
29.
Matthews LS, Kaufer H, Garver DF, et al. The effect on supination-pronation of angular malalignment of fractures of both bones of the forearm. J Bone Joint Surg Am. 1982;64(1):14–7.PubMed
30.
Merle d’Aubigné R, Descamps L. L’osté otomie plane oblique dans la correction des deformations des membres. Bull Mem Arch Chir. 1952;8:271–6.
31.
Meyer DC, Siebenrock KA, Schiele B, et al. A new methodology for the planning of single-cut corrective osteotomies of mal-aligned long bones. Clin Biomech. 2005;20:223–7. Bristol, Avon.CrossRef
32.
Miyake J, Murase T, Oka K, et al. Computer-assisted corrective osteotomy for malunited diaphyseal forearm fractures. J Bone Joint Surg (Am). 2012;94(20):e150.CrossRef
33.
Morrey BF, Askew LJ, An KN, et al. A biomechanical study of normal functional elbow motion. J Bone Joint Surg. 1981;63(6):872–7.PubMed
34.
Muller ME, Allgower M, Willenegger H. Technique of internal fixation of fractures. New York: Springer-Verlag; 1965.CrossRef
35.
Murase T, Oka K, Moritomo H, et al. Three-dimensional corrective osteotomy of malunited fractures of the upper extremity with use of a computer simulation system. J Bone Joint Surg Am. 2008;90:2375–89.PubMedCrossRef
36.
37.
Nagy L. Malunion of the distal end of the radius. In: Fernandez DL, Jupiter JB, editors. Fractures of the distal radius, a practical approach to management. New York: Springer; 2002. p. 289–344.CrossRef
38.
Poitevin LA. Anatomy and biomechanics of the interosseous membrane: its importance in the longitudinal stability of the forearm. Hand Clin. 2001;17:97-110, vii.
39.
Price CT, Knapp DR. Osteotomy for malunited forearm shaft fractures in children. J Pediatr Orthop. 2006;26:193–6.PubMedCrossRef
40.
Prommersberger KJ, Van Schoonhoven J, Lanz UB. Outcome after corrective osteotomy for malunited fractures of the distal end of the radius. J Hand Surg (Br). 2002;27:55–60.CrossRef
41.
Rabinowitz RS, Light TR, Havey RM, et al. The role of the interosseous membrane and triangular fibrocartilage complex in forearm stability. J Hand Surg [Am]. 1994;19:385–93.CrossRef
42.
Richard MJ, Ruch DS, Aldridge 3rd JM. Malunions and nonunions of the forearm. Hand Clin. 2007;23(2):235–43.PubMedCrossRef
43.
Ross ER, Gourevitch D, Hastings GW, et al. Retrospective analysis of plate fixation of diaphyseal fractures of forearm bones. Injury. 1989;20(4):211–4.PubMedCrossRef
44.
Saffar P. Ulna oblique osteotomy for radius and ulna length inequality: technique and applications. Tech Hand Upper Extrem Surg. 2006;10:47–53.CrossRef
45.
Sangeorzan BP, Judd RP, Sangeorzan BJ. Mathematical analysis of single-cut osteotomy for complex long bone deformity. J Biomech. 1989;22:1271–8.PubMedCrossRef
46.
Sardelli M, Tashjian RZ, MacWilliams BA. Functional elbow range of motion for contemporary tasks. J Bone Joint Surg Am. 2011;93(5):471–7.PubMedCrossRef
47.
Sarmiento A, Ebramzadeh E, Brys D, et al. Angular deformities and forearm function. J Orthop Res. 1992;10(1):121–33.PubMedCrossRef
48.
Schemitsch EH, Richards RR. The effect of malunion on functional outcome after plate fixation of fractures of both bones of the forearm in adults. J Bone Joint Surg Am. 1992;74(7):1068–78.PubMed
49.
Schmittenbecher PP. State-of-the-art treatment of forearm shaft fractures. Injury. 2005;36 suppl 1:A25–34.PubMedCrossRef
50.
Schweizer A. Complex radius shaft malunion: osteotomy with computer-assisted planning. Hand (NY). 2010;5(2):171–8.CrossRef
51.
Stern PJ, Drury WJ. Complications of plate fixation of forearm fractures. Clin Orthop Relat Res. 1983;175:25–9.PubMed
52.
Szabo RM. Distal radioulnar joint instability. Instr Course Lect. 2007;56:79–89.PubMed
53.
Tarr RR, Garfinkel AI, Sarmiento A. The effects of angular and rotational deformities of both bones of the forearm: an in vitro study. J Bone Joint Surg Am. 1984;66(1):65–70.PubMed
54.
Trousdale RT, Linscheid RL. Operative treatment of malunited fractures of the forearm. J Bone Joint Surg Am. 1995;77(6):894–902.PubMed
55.
Tynan MC, Fornalski S, McMahon PJ, et al. The effect of ulnar axial malalignment on supination and pronation. J Bone Joint Surg Am. 2000;82:1726–31.PubMed
56.
van Geenen RC, Besselaar PP. Outcome after corrective osteotomy for malunited fractures of the forearm sustained in childhood. J Bone Joint Surg (Br). 2007;89:236–9.CrossRef
57.
Yasutomi T, Nakatsuchi Y, Koike H, et al. Mechanism of limitation of pronation/supination of the forearm in geometric models of deformities of the forearm bones. Clin Biomech. 2002;17(6):456–63. Bristol, Avon.CrossRef
58.
Zancolli EA. Paralytic supination contracture of the forearm. J Bone Joint Surg Am. 1967;49:1275–84.PubMed
Metadata
Title
Reconstruction of malunited diaphyseal fractures of the forearm
Authors
Prakash Jayakumar
Jesse B Jupiter
Publication date
01-09-2014
Publisher
Springer US
Published in
HAND / Issue 3/2014
Print ISSN: 1558-9447
Electronic ISSN: 1558-9455
DOI
https://doi.org/10.1007/s11552-014-9635-9

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