SURGICAL TREATMENT OF MALUNITED COLLES??? FRACTURE BY CORRECTIVE OSTEOTOMY

Abstract

Gopinath K. M1 , Pramod Kumar M2 , Venkatdeep Mohan 3

Malunion occurs more often after Colles fracture than any other and can result in considerable disability. Multiple techniques for corrective osteotomy have been developed in recent years with objective of restoring the normal anatomy of distal end of radius and also to evaluate the results with respect to pain, restoration of function of wrist and forearm. MATERIALS AND METHODS A prospective randomized controlled study was conducted in 20 cases of malunited Colles fracture who underwent Corrective osteotomy with a Dorsal Ellis T plate and bone graft. Post operatively all patients were immobilized on a Sugar-Tong splint and followed up at 4, 6 and 12 weeks. RESULTS All measurements of Pain, final range of motion and grip strength significantly improved compared with preoperative measurements. Based on Fernandez et al scoring system we obtained Excellent results in 8 cases, Good in 7 cases, Fair in 3 cases and Poor in 2 cases which was attributed to infection in 1 case and RSD in the other case. Radiologically a mean radial length of 6.14mm (N:10mm), Radial Angle of 21.25? (N:22?) and Volar angle of -3.4? (N: +4?) was achieved. CONCLUSION Corrective Osteotomy with Bone graft is a preferred and an Ideal procedure if performed after Proper selection of patients i.e in young adults and extra articular malunions with good range of movements.

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