Two bone fragment manipulation in computer-assisted preoperative planning: Restoration of the radial bow

Abstract

Distal radius fractures are the most common fracture seen in hospital emergency departments. While most patients have a good outcome, a small percentage of fractures heal in a displaced position (malunion), which may cause pain, stiffness, and weakness of the wrist and forearm. We have developed a computer-assisted technique for correction (osteotomy) of distal radius malunion. Outcome studies have shown that this procedure is accurate, reliable, and safe. It has advantages over a computer-assisted conventional technique, including less fluoroscopic radiation to the patient and surgical team, and a quicker learning curve for non-expert surgeons. Our initial technique corrected only the initial fragment of the radius, leaving the proximal radius unchanged (relative to the ulna which is the fixed uninvolved element in the forearm in these cases). A new development reported here is the incorporation of correction of the proximal radius. This allows for full correction of the radial ulnar convergence, restoring the bow of the radius. We noted improved fixation plate positioning and full forearm rotation post operatively.