{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T20:53:18Z","timestamp":1793393598624,"version":"4.5.0"},"reference-count":13,"publisher":"Georg Thieme Verlag KG","issue":"02","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Wrist Surg"],"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Background\u2003Extra-articular fractures of the distal radius are often treated with a trial of nonoperative management if radiographic parameters are within an acceptable range, especially in the elderly population. Unfortunately, some malunions become symptomatic or become grossly misaligned during nonoperative management which require corrective surgery to restore the normal osseous anatomy and restore function.<\/jats:p><jats:p>\n          Description of Technique\u2003We describe correction of a distal radius malunion utilizing a distraction-type volar osteotomy, a volar plate specific distraction device, and a novel resorbable calcium phosphate bone cement (Trabexus) designed to withstand compressive loads.<\/jats:p><jats:p>\n          Patients and Methods\u2003Twelve patients with 13 distal radius fractures were included in this study. The average patient age was 60.9 years and average time from injury to corrective osteotomy was 96.3 days. Radiographic measures (radial inclination, volar tilt, and ulnar variance) and clinical assessment (wrist\/forearm range of motion and grip strength) were done pre- and postoperatively and compared.<\/jats:p><jats:p>\n          Results\u2003The average time from corrective surgical osteotomy to final clinical follow-up was 375.8 days. After surgical intervention, there was a statistically significant improvement in mean volar tilt (\u221219.8 vs. +0.5 degrees) and mean ulnar variance (+2.8 vs. \u22120.4\u2009mm). Improvements were also seen in grip strength (1.7 vs. 43.6 lb), wrist flexion (30.5 vs. 48.3 degrees), wrist extension (33.3 vs. 53.8 degrees), forearm pronation (75.0 vs. 88.8 degrees), and forearm supination (53.8 vs. 81.3 degrees). On average, 56.0% of Trabexus bone substitute remained on final clinical radiographs.<\/jats:p><jats:p>\n          Conclusion\u2003This simplified technique of distraction corrective osteotomy after distal radius malunion results in improved clinical and radiographic outcomes for patients.<\/jats:p>","DOI":"10.1055\/s-0041-1726293","type":"journal-article","created":{"date-parts":[[2021,3,24]],"date-time":"2021-03-24T23:40:11Z","timestamp":1616629211000},"page":"185-190","source":"Crossref","is-referenced-by-count":6,"title":["Simplifying the Volar Distraction Osteotomy for Distal Radius Malunion Repair"],"prefix":"10.1055","volume":"11","author":[{"given":"Luke P.","family":"Robinson","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Norton Louisville Arm and Hand, Louisville, Kentucky"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rashad H.","family":"Usmani","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Louisville, Louisville, Kentucky"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victor","family":"Fehrenbacher","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Norton Louisville Arm and Hand, Louisville, Kentucky"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren","family":"Protzer","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Louisville, Louisville, Kentucky"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2021,3,24]]},"reference":[{"issue":"04","key":"ref1","doi-asserted-by":"crossref","first-page":"537","DOI":"10.1007\/s00776-014-0560-0","article-title":"Outcomes and complications of fractures of distal radius (AO type B and C): volar plating versus nonoperative treatment","volume":"19","author":"H Sharma","year":"2014","journal-title":"J Orthop Sci"},{"issue":"03","key":"ref2","doi-asserted-by":"crossref","first-page":"292","DOI":"10.3109\/17453674.2013.792035","article-title":"Epidemiology and changed surgical treatment methods for fractures of the distal radius: a registry analysis of 42,583 patients in Stockholm County, Sweden, 2004\u20132010","volume":"84","author":"M K Wilcke","year":"2013","journal-title":"Acta Orthop"},{"issue":"02","key":"ref3","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1053\/jhsu.2002.32083","article-title":"The effects of dorsally angulated distal radius fractures on carpal kinematics","volume":"27","author":"M J Park","year":"2002","journal-title":"J Hand Surg Am"},{"issue":"07","key":"ref4","doi-asserted-by":"crossref","first-page":"962","DOI":"10.1016\/j.jhsa.2007.05.009","article-title":"The risk of adverse outcomes in extra-articular distal radius fractures is increased with malalignment in patients of all ages but mitigated in older patients","volume":"32","author":"R Grewal","year":"2007","journal-title":"J Hand Surg Am"},{"issue":"08","key":"ref5","doi-asserted-by":"crossref","first-page":"1164","DOI":"10.2106\/00004623-198264080-00007","article-title":"Correction of post-traumatic wrist deformity in adults by osteotomy, bone-grafting, and internal fixation","volume":"64","author":"D L Fernandez","year":"1982","journal-title":"J Bone Joint Surg Am"},{"issue":"02","key":"ref6","doi-asserted-by":"crossref","first-page":"194","DOI":"10.1177\/1558944716685831","article-title":"Ulnar shortening versus distal radius corrective osteotomy in the management of ulnar impaction after distal radius malunion","volume":"13","author":"W R Aibinder","year":"2018","journal-title":"Hand (N Y)"},{"issue":"06","key":"ref7","doi-asserted-by":"crossref","first-page":"1106","DOI":"10.1016\/j.jhsa.2013.03.015","article-title":"Isolated ulnar shortening osteotomy for the treatment of extra-articular distal radius malunion","volume":"38","author":"R C Srinivasan","year":"2013","journal-title":"J Hand Surg Am"},{"key":"ref8","first-page":"30","article-title":"Ulnar shortening osteotomy for distal radius fractures","volume":"46","author":"R N Kamal","year":"2012","journal-title":"Acta Orthop Traumatol Turc"},{"issue":"03","key":"ref9","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1016\/j.hcl.2005.02.008","article-title":"Essential radiographic evaluation for distal radius fractures","volume":"21","author":"R J Medoff","year":"2005","journal-title":"Hand Clin"},{"issue":"02","key":"ref10","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1053\/jhsu.2002.32076","article-title":"Osteotomy for malunited fractures of the distal radius: a comparison of structural and nonstructural autogenous bone grafts","volume":"27","author":"D Ring","year":"2002","journal-title":"J Hand Surg Am"},{"issue":"05","key":"ref11","doi-asserted-by":"crossref","first-page":"825","DOI":"10.1016\/j.jhsa.2004.06.004","article-title":"Corrective osteotomy of malunited distal radius fractures using carbonated hydroxyapatite as an alternative to autogenous bone grafting","volume":"29","author":"R Luchetti","year":"2004","journal-title":"J Hand Surg Am"},{"issue":"03","key":"ref12","doi-asserted-by":"crossref","first-page":"395","DOI":"10.1016\/j.jhsa.2015.10.029","article-title":"Extensor pollicis longus ruptures following distal radius osteotomy through a volar approach","volume":"41","author":"M Rivlin","year":"2016","journal-title":"J Hand Surg Am"},{"issue":"11","key":"ref13","doi-asserted-by":"crossref","first-page":"987.e1","DOI":"10.1016\/j.jhsa.2018.12.013","article-title":"Complications of corrective osteotomies for extra-articular distal radius malunion","volume":"44","author":"J C Haghverdian","year":"2019","journal-title":"J Hand Surg Am"}],"container-title":["Journal of Wrist Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0041-1726293.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,4,26]],"date-time":"2022-04-26T00:08:26Z","timestamp":1650931706000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0041-1726293"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,3,24]]},"references-count":13,"journal-issue":{"issue":"02","published-online":{"date-parts":[[2022,4,25]]},"published-print":{"date-parts":[[2022,4]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0041-1726293","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["2163-3916","2163-3924"],"issn-type":[{"value":"2163-3916","type":"print"},{"value":"2163-3924","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,3,24]]}}}