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
UR - http://www.scopus.com/inward/record.url?scp=33745714175&partnerID=8YFLogxK
U2 - 10.1016/j.jhsa.2006.01.010
DO - 10.1016/j.jhsa.2006.01.010
M3 - Article
C2 - 16843157
AN - SCOPUS:33745714175
SN - 0363-5023
VL - 31
SP - 968
EP - 972
JO - Journal of Hand Surgery
JF - Journal of Hand Surgery
IS - 6
ER -