Both-Bone Forearm Osteotomy for Supination Contracture

A Cadaver Model

Douglas T. Hutchinson, Angela A. Wang, Daniel Ryssman, N. A T Brown

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Purpose: To quantify the magnitude of rotational correction possible when comparing a single forearm bone osteotomy and fixation with stepwise osteotomy and fixation of both bones in a cadaver model and to determine if the order in which the stepwise osteotomies are performed influences the amount of correction. Methods: Ten fresh-frozen cadaveric forearms were fixed to a frame positioned in the field of view of a motion-capture system. An experimental supination contracture was induced in full supination. Cadaver forearms were assigned randomly to group I (ulna osteotomy, rotation, plating) or group II (radius osteotomy, rotation, plating). Cadavers in group I were used later in group III (ulna + radius) by completing a radial osteotomy, rotation, and fixation in the forearms with the plated ulna. Similarly the specimens assigned to group II were used later in group IV (radius + ulna) by completing an ulna osteotomy, rotation, and fixation in the forearms with the plated radiuses. Measurements of forearm pronation were made after single-bone (groups I, II) and stepwise both-bone (groups III, IV) rotational osteotomies. Results: Stepwise rotational osteotomy and fixation of the ulna followed by the radius produced significantly more corrective pronation (101°) than rotating the radius followed by the ulna (65°). Rotating the radius gave only moderate correction (58°) and minimal correction was produced by ulna osteotomy alone (15°). Conclusions: Rotational osteotomy of both forearm bones can create approximately 100° of correction when performed at the proximal ulna followed by the distal radius. If less rotation is needed then the distal radius osteotomy alone can provide approximately 60° of correction.

Original languageEnglish
Pages (from-to)968-972
Number of pages5
JournalJournal of Hand Surgery
Volume31
Issue number6
DOIs
Publication statusPublished - 2006
Externally publishedYes

Fingerprint

Supination
Contracture
Osteotomy
Cadaver
Forearm
Ulna
Bone and Bones
Pronation

Cite this

Hutchinson, Douglas T. ; Wang, Angela A. ; Ryssman, Daniel ; Brown, N. A T. / Both-Bone Forearm Osteotomy for Supination Contracture : A Cadaver Model. In: Journal of Hand Surgery. 2006 ; Vol. 31, No. 6. pp. 968-972.
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abstract = "Purpose: To quantify the magnitude of rotational correction possible when comparing a single forearm bone osteotomy and fixation with stepwise osteotomy and fixation of both bones in a cadaver model and to determine if the order in which the stepwise osteotomies are performed influences the amount of correction. Methods: Ten fresh-frozen cadaveric forearms were fixed to a frame positioned in the field of view of a motion-capture system. An experimental supination contracture was induced in full supination. Cadaver forearms were assigned randomly to group I (ulna osteotomy, rotation, plating) or group II (radius osteotomy, rotation, plating). Cadavers in group I were used later in group III (ulna + radius) by completing a radial osteotomy, rotation, and fixation in the forearms with the plated ulna. Similarly the specimens assigned to group II were used later in group IV (radius + ulna) by completing an ulna osteotomy, rotation, and fixation in the forearms with the plated radiuses. Measurements of forearm pronation were made after single-bone (groups I, II) and stepwise both-bone (groups III, IV) rotational osteotomies. Results: Stepwise rotational osteotomy and fixation of the ulna followed by the radius produced significantly more corrective pronation (101°) than rotating the radius followed by the ulna (65°). Rotating the radius gave only moderate correction (58°) and minimal correction was produced by ulna osteotomy alone (15°). Conclusions: Rotational osteotomy of both forearm bones can create approximately 100° of correction when performed at the proximal ulna followed by the distal radius. If less rotation is needed then the distal radius osteotomy alone can provide approximately 60° of correction.",
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Both-Bone Forearm Osteotomy for Supination Contracture : A Cadaver Model. / Hutchinson, Douglas T.; Wang, Angela A.; Ryssman, Daniel; Brown, N. A T.

In: Journal of Hand Surgery, Vol. 31, No. 6, 2006, p. 968-972.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Both-Bone Forearm Osteotomy for Supination Contracture

T2 - A Cadaver Model

AU - Hutchinson, Douglas T.

AU - Wang, Angela A.

AU - Ryssman, Daniel

AU - Brown, N. A T

PY - 2006

Y1 - 2006

N2 - Purpose: To quantify the magnitude of rotational correction possible when comparing a single forearm bone osteotomy and fixation with stepwise osteotomy and fixation of both bones in a cadaver model and to determine if the order in which the stepwise osteotomies are performed influences the amount of correction. Methods: Ten fresh-frozen cadaveric forearms were fixed to a frame positioned in the field of view of a motion-capture system. An experimental supination contracture was induced in full supination. Cadaver forearms were assigned randomly to group I (ulna osteotomy, rotation, plating) or group II (radius osteotomy, rotation, plating). Cadavers in group I were used later in group III (ulna + radius) by completing a radial osteotomy, rotation, and fixation in the forearms with the plated ulna. Similarly the specimens assigned to group II were used later in group IV (radius + ulna) by completing an ulna osteotomy, rotation, and fixation in the forearms with the plated radiuses. Measurements of forearm pronation were made after single-bone (groups I, II) and stepwise both-bone (groups III, IV) rotational osteotomies. Results: Stepwise rotational osteotomy and fixation of the ulna followed by the radius produced significantly more corrective pronation (101°) than rotating the radius followed by the ulna (65°). Rotating the radius gave only moderate correction (58°) and minimal correction was produced by ulna osteotomy alone (15°). Conclusions: Rotational osteotomy of both forearm bones can create approximately 100° of correction when performed at the proximal ulna followed by the distal radius. If less rotation is needed then the distal radius osteotomy alone can provide approximately 60° of correction.

AB - Purpose: To quantify the magnitude of rotational correction possible when comparing a single forearm bone osteotomy and fixation with stepwise osteotomy and fixation of both bones in a cadaver model and to determine if the order in which the stepwise osteotomies are performed influences the amount of correction. Methods: Ten fresh-frozen cadaveric forearms were fixed to a frame positioned in the field of view of a motion-capture system. An experimental supination contracture was induced in full supination. Cadaver forearms were assigned randomly to group I (ulna osteotomy, rotation, plating) or group II (radius osteotomy, rotation, plating). Cadavers in group I were used later in group III (ulna + radius) by completing a radial osteotomy, rotation, and fixation in the forearms with the plated ulna. Similarly the specimens assigned to group II were used later in group IV (radius + ulna) by completing an ulna osteotomy, rotation, and fixation in the forearms with the plated radiuses. Measurements of forearm pronation were made after single-bone (groups I, II) and stepwise both-bone (groups III, IV) rotational osteotomies. Results: Stepwise rotational osteotomy and fixation of the ulna followed by the radius produced significantly more corrective pronation (101°) than rotating the radius followed by the ulna (65°). Rotating the radius gave only moderate correction (58°) and minimal correction was produced by ulna osteotomy alone (15°). Conclusions: Rotational osteotomy of both forearm bones can create approximately 100° of correction when performed at the proximal ulna followed by the distal radius. If less rotation is needed then the distal radius osteotomy alone can provide approximately 60° of correction.

KW - forearm pronation

KW - radial osteotomy

KW - Supination contracture

KW - ulnar osteotomy

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U2 - 10.1016/j.jhsa.2006.01.010

DO - 10.1016/j.jhsa.2006.01.010

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VL - 31

SP - 968

EP - 972

JO - Journal of Hand Surgery

JF - Journal of Hand Surgery

SN - 0363-5023

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