Kindly give your suggestions especially with regards to what implant to use
45 yr old man, h/o fall and # R distal radius-1 yr ago
[Previously 10 yrs ago # L distal radius]
Treated by POP cast
Malunion with severe dorsal tilt and pain on lifting weights
Range of motion: -Dorsiflexion=40 Palmar flexion=40 Ulnar and radial deviation =20
Supination full Pronation restriction last 20 deg
My plan- dorsal opening wedge osteotomy and bone graft- my question is what implant to use?
Attaching requisite x-rays
DR C CHERIYAN KOVOOR
On Nov 28, 2022, at 6:32 PM, CHERRY KOVOOR <kovo...@gmail.com> wrote:
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<Inj AP4-10-21.jpg><iNJ 1-11-21lat.jpg><latest 20-11-22AP.jpg><latest 20-11-22LAT.jpg>
I agree with David Nelson
I have my distal radius plate (one that I developed) but will often use another for say peri-articular applications.
I would be wary of 10 yr old malunions especially with respect to the DRUJ. Expect some loss of supination.
Also, there will be an adaptive DISI which may not fully correct.
Is there an ulna plus? If so avoid losing volar bone contact. You can always shorten the ulna, now or later.
I do a CT scan and then use the Ilizarov oblique plane planning to determine the exact position of the opening wedge.
Any locking plate will do. The simpler the better. Use an anatomic plate as a volar buttress / template against which to reduce. Accept 0-5 deg volar tilt; patients are happier.
Prof. Minoo Patel MBBS, MS, FRACS, Ph.D.
Adjunct Professor, RMIT University ǀ Senior Lecturer Monash University ǀ Research Fellow Melbourne University
Past Chair, Australian Orthopaedic Association Research Foundation
Suite 5.7. The Epworth Centre, 32 Erin St, Richmond. VIC 3121
Ph: 03 9429 8084 Fax: 03 94294045 Mobile: 0418 418 728
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On Nov 29, 2022, at 5:01 AM, Minoo Patel <minoo...@bigpond.com> wrote:
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