Computer-assisted distal radius osteotomy

Purpose: To establish the accuracy, precision, and clinical feasibility of a novel technique of computer-assisted distal radius osteotomy for the correction of symptomatic distal radius malunion. Methods: Six patients underwent a computer-assisted distal radius osteotomy and were followed-up for an average of 25 months. Objective radiographic measurements and functional outcomes, as measured by clinical examination including grip strength and range of motion, and Disability of the Arm, Shoulder and Hand (DASH) questionnaires, were used. Results: The mean radiographic parameters included an increase of radial inclination to 21degrees from 12degrees (normal, 23degrees). Dorsal and volar tilt (malunion) were corrected to 9degrees from -30degrees and 21degrees, respectively (normal, 10degrees). Ulnar variance was corrected to 1.9 mm from 7.5 mm (normal, +1.5 mm). Normal is defined as the average of the contralateral limb radiographs. The mean clinical outcome measures at an average of 25 months included a DASH global score of 14, a DASH individual item average score of 1.6, and and average affected side grip strength of 79% when compared with the unaffected side. Conclusions: The results of the computer-assisted technique were comparable with published results of traditional non-computer-assisted technique were comparable with published results of traditional non-computer-assisted opening wedge osteotomy techniques. This technique allows a surgeon to accurately and precisely recognise and correct 3-dimensional deformities of the distal radius including axial malalignment (supination). The technique has the added benefit of reducing radiation exposure to the patient and surgical team because fluoroscopy include the ability to perform multiple surgical simulations to optimize the alignment plan, and it serves as an excellent teaching tool for less-experienced surgeons. Copyright (C) 2002 by the American Society for Surgery of the Hand.