Summary of – Outcomes of radialization with ulnar cuff osteotomy for radial longitudinal deficiency: a medium-term follow-up study

Document Type

Article

Abstract

Study Background: The goal in managing radial longitudinal deficiency (RLD) is to correct the deformity at the wrist by aligning the distal ulna on the carpus, to achieve a stable wrist and centralized hand. Various ulnar sided and centralization procedures have tried to achieve ulnocarpal alignment but they lead to intercarpal fusion, a stiff wrist and possibly growth disturbance. This study evaluates the long-term outcomes of a novel surgical technique, radialization with ulnar cuff osteotomy, specifically designed to correct wrist deformities associated with RLD in children.

Research Goals and Hypotheses: The primary aim of the study was to assess the effectiveness of radialization with ulnar cuff osteotomy in maintaining wrist alignment and promoting ulnar growth in children diagnosed with RLD. Secondary outcomes included measuring changes in hand-forearm angle (HFA), hand-forearm position (HFP), and ulnar length over an average follow-up period.

Methodological Approach: A cohort of 17 patients, with a mean age of 14 months at surgery, had mean follow-up period of 66 months. The technique involved performing a subperiosteal ulnar cuff osteotomy that allowed for the distraction of the ulna, aiming to reduce carpal overlap and relieve radial forces. Statistical analyses were undertaken using paired sample t-tests to establish the significance of surgical outcomes.

Results and Discoveries: At final follow-up, significant improvements were noted, demonstrating a shift from radial to ulnar deviation, positive adjustment, aligning better with the distal ulna. As well as retention of ulnar length at 62% of the unaffected side, showing healthy longitudinal growth for the affected limb. Complications were limited, with no reports of major adverse effects such as nonunion or fractures at the osteotomy site. The study concludes that the radialization with ulnar cuff osteotomy is an effective surgical approach for managing RLD in children. It consistently maintains wrist alignment over the medium term while promoting healthy growth of the ulnar bone.

Publication Year: 2023

Publication Date

2023

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