Accuracy of 3D Corrective Osteotomy for Pediatric Malunited Both-Bone Forearm Fractures
Re-displacement of a pediatric diaphyseal forearm fracture can lead to a malunion with symptomatic impairment in forearm rotation, which may require a corrective osteotomy. Corrective osteotomy with two-dimensional (2D) radiographic planning for malunited pediatric forearm fractures can be a complex...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-12-01
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| Series: | Children |
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| Online Access: | https://www.mdpi.com/2227-9067/10/1/21 |
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| author | Kasper Roth Eline van Es Gerald Kraan Denise Eygendaal Joost Colaris Filip Stockmans |
| author_facet | Kasper Roth Eline van Es Gerald Kraan Denise Eygendaal Joost Colaris Filip Stockmans |
| author_sort | Kasper Roth |
| collection | DOAJ |
| description | Re-displacement of a pediatric diaphyseal forearm fracture can lead to a malunion with symptomatic impairment in forearm rotation, which may require a corrective osteotomy. Corrective osteotomy with two-dimensional (2D) radiographic planning for malunited pediatric forearm fractures can be a complex procedure due to multiplanar deformities. Three-dimensional (3D) corrective osteotomy can aid the surgeon in planning and obtaining a more accurate correction and better forearm rotation. This prospective study aimed to assess the accuracy of correction after 3D corrective osteotomy for pediatric forearm malunion and if anatomic correction influences the functional outcome. Our primary outcome measures were the residual maximum deformity angle (MDA) and malrotation after 3D corrective osteotomy. Post-operative MDA > 5° or residual malrotation > 15° were defined as non-anatomic corrections. Our secondary outcome measure was the gain in pro-supination. Between 2016–2018, fifteen patients underwent 3D corrective osteotomies for pediatric malunited diaphyseal both-bone fractures. Three-dimensional corrective osteotomies provided anatomic correction in 10 out of 15 patients. Anatomic corrections resulted in a greater gain in pro-supination than non-anatomic corrections: 70° versus 46° (<i>p</i> = 0.04, ANOVA). Residual malrotation of the radius was associated with inferior gain in pro-supination (<i>p</i> = 0.03, multi-variate linear regression). Three-dimensional corrective osteotomy for pediatric forearm malunion reliably provided an accurate correction, which led to a close-to-normal forearm rotation. Non-anatomic correction, especially residual malrotation of the radius, leads to inferior functional outcomes. |
| first_indexed | 2024-03-09T13:11:08Z |
| format | Article |
| id | doaj.art-efb8b15b66a3472f8766e713056e9ffb |
| institution | Directory Open Access Journal |
| issn | 2227-9067 |
| language | English |
| last_indexed | 2024-03-09T13:11:08Z |
| publishDate | 2022-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Children |
| spelling | doaj.art-efb8b15b66a3472f8766e713056e9ffb2023-11-30T21:42:35ZengMDPI AGChildren2227-90672022-12-011012110.3390/children10010021Accuracy of 3D Corrective Osteotomy for Pediatric Malunited Both-Bone Forearm FracturesKasper Roth0Eline van Es1Gerald Kraan2Denise Eygendaal3Joost Colaris4Filip Stockmans5Department of Orthopedics and Sports Medicine, Erasmus University Medical Centre, Dr. Molewaterplein 40, 3015 GD Rotterdam, The NetherlandsDepartment of Orthopedics and Sports Medicine, Erasmus University Medical Centre, Dr. Molewaterplein 40, 3015 GD Rotterdam, The NetherlandsDepartment of Orthopedics, Reinier HAGA Orthopedic Centre, Toneellaan 2, 2725 NA Zoetermeer, The NetherlandsDepartment of Orthopedics and Sports Medicine, Erasmus University Medical Centre, Dr. Molewaterplein 40, 3015 GD Rotterdam, The NetherlandsDepartment of Orthopedics and Sports Medicine, Erasmus University Medical Centre, Dr. Molewaterplein 40, 3015 GD Rotterdam, The NetherlandsDepartment of Development and Regeneration, Faculty of Medicine, University of Leuven Campus Kortrijk, Etienne Sabbelaan 53, 8500 Kortrijk, BelgiumRe-displacement of a pediatric diaphyseal forearm fracture can lead to a malunion with symptomatic impairment in forearm rotation, which may require a corrective osteotomy. Corrective osteotomy with two-dimensional (2D) radiographic planning for malunited pediatric forearm fractures can be a complex procedure due to multiplanar deformities. Three-dimensional (3D) corrective osteotomy can aid the surgeon in planning and obtaining a more accurate correction and better forearm rotation. This prospective study aimed to assess the accuracy of correction after 3D corrective osteotomy for pediatric forearm malunion and if anatomic correction influences the functional outcome. Our primary outcome measures were the residual maximum deformity angle (MDA) and malrotation after 3D corrective osteotomy. Post-operative MDA > 5° or residual malrotation > 15° were defined as non-anatomic corrections. Our secondary outcome measure was the gain in pro-supination. Between 2016–2018, fifteen patients underwent 3D corrective osteotomies for pediatric malunited diaphyseal both-bone fractures. Three-dimensional corrective osteotomies provided anatomic correction in 10 out of 15 patients. Anatomic corrections resulted in a greater gain in pro-supination than non-anatomic corrections: 70° versus 46° (<i>p</i> = 0.04, ANOVA). Residual malrotation of the radius was associated with inferior gain in pro-supination (<i>p</i> = 0.03, multi-variate linear regression). Three-dimensional corrective osteotomy for pediatric forearm malunion reliably provided an accurate correction, which led to a close-to-normal forearm rotation. Non-anatomic correction, especially residual malrotation of the radius, leads to inferior functional outcomes.https://www.mdpi.com/2227-9067/10/1/21corrective osteotomythree-dimensionalmalunionfractureforearmradius |
| spellingShingle | Kasper Roth Eline van Es Gerald Kraan Denise Eygendaal Joost Colaris Filip Stockmans Accuracy of 3D Corrective Osteotomy for Pediatric Malunited Both-Bone Forearm Fractures Children corrective osteotomy three-dimensional malunion fracture forearm radius |
| title | Accuracy of 3D Corrective Osteotomy for Pediatric Malunited Both-Bone Forearm Fractures |
| title_full | Accuracy of 3D Corrective Osteotomy for Pediatric Malunited Both-Bone Forearm Fractures |
| title_fullStr | Accuracy of 3D Corrective Osteotomy for Pediatric Malunited Both-Bone Forearm Fractures |
| title_full_unstemmed | Accuracy of 3D Corrective Osteotomy for Pediatric Malunited Both-Bone Forearm Fractures |
| title_short | Accuracy of 3D Corrective Osteotomy for Pediatric Malunited Both-Bone Forearm Fractures |
| title_sort | accuracy of 3d corrective osteotomy for pediatric malunited both bone forearm fractures |
| topic | corrective osteotomy three-dimensional malunion fracture forearm radius |
| url | https://www.mdpi.com/2227-9067/10/1/21 |
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