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Corrective Osteotomy After Damage of the Distal Radial Physis in Children: Surgical Technique and Results

Kaempf de Oliveira, Ricardo MD*; Serrano, Pedro J. Delgado MD; Badia, Alejandro MD; Ferreira, Marco Tonding MD§

Techniques in Hand & Upper Extremity Surgery: December 2011 - Volume 15 - Issue 4 - p 236–242
doi: 10.1097/BTH.0b013e31821da4b5
Techniques

Distal radial physis closure in children can develop severe wrist deformity (radial shortening). These patients can be treated using a single-step surgery. It was carried out in the form of a corrective osteotomy adopting the volar approach, with fixed-angle volar plate fixation and bone grafting from the iliac crest. There have been few descriptions of the use of this technique in the management of deformities related to early epiphysiodesis in distal radius. The use of fixation systems for the radius, using fixed-angle locking plates, allows radius lengthening adjusted to demand after osteotomy, using the combination of the plate and distal locking pins as spacer—with custom-sized tricortical iliac crest grafting within the defect. The freeing of soft parts such as the dorsal periosteum and brachioradialis muscle tendon allows adequate bone lengthening in a single-surgical step.

*Instituto da Mão, Complexo Hospitalar Santa Casa and Hospital Mãe de Deus

§Complexo Hospitalar Santa Casa, Porto Alegre, RS, Brazil

Unidad de Cirugía de la Mano y Miembro Superior, Hospital FREMAP, Centro de Prevención y Rehabilitación, Majadahonda (Madrid), Spain

Badia Hand to Shoulder Center, Hand and Upper Extremity Surgery, Doral, FL

Conflicts of Interest: The authors disclose that they have not received any monetary aid to perform this study. They did not make any deal whatsoever to receive benefits or honorary from any commercial part.

No commercial part has paid—or will pay—to foundations, educational institutions, or other nonprofit organizations that the authors are affiliated to.

Address correspondence and reprint requests to Ricardo Kaempf de Oliveira, MD, Leopoldo Bier Street, 825/301, Porto Alegre, Brazil 90620-100. e-mail: ricardokaempf@gmail.com.

© 2011 Lippincott Williams & Wilkins, Inc.