Systematic Reviews
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Feb 18, 2016; 7(2): 128-135
Published online Feb 18, 2016. doi: 10.5312/wjo.v7.i2.128
Corrective osteotomies of the radius: Grafting or not?
Raffaele Mugnai, Luigi Tarallo, Enrico Lancellotti, Francesco Zambianchi, Ettore Di Giovine, Fabio Catani, Roberto Adani
Raffaele Mugnai, Luigi Tarallo, Enrico Lancellotti, Francesco Zambianchi, Ettore Di Giovine, Fabio Catani, Orthopedics and Traumatology Department, Modena Policlinic, University of Modena and Reggio Emilia, 41124 Modena, Italy
Roberto Adani, Department of Hand Surgery and Microsurgery, University Hospital Policlinico di Modena, 41124 Modena, Italy
Author contributions: Mugnai R, Catani F and Adani R designed the research; Lancellotti E and Di Giovine E performed the research; Mugnai R, Tarallo L and Zambianchi F wrote the paper.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest concerning this article.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Raffaele Mugnai, MD, Orthopedics and Traumatology Department, Modena Policlinic, University of Modena and Reggio Emilia, via del Pozzo 71, 41124 Modena, Italy. raffaele.mugnai@gmail.com
Telephone: +39-059-4223717 Fax: +39-059-4224313
Received: July 4, 2015
Peer-review started: July 12, 2015
First decision: September 30, 2015
Revised: November 14, 2015
Accepted: December 7, 2015
Article in press: December 8, 2015
Published online: February 18, 2016
Abstract

AIM: To review the current literature regarding corrective osteotomies to provide the best evidence of the rule of bone grafting.

METHODS: Our MEDLINE literature search included 280 studies using the following key words “Malunited distal radius fracture” and 150 studies using key words “Corrective osteotomy of the distal radius”. Inclusion criteria were: Malunited distal radial, extra articular fracture, volar locking plate, use of iliac bone graft (cancellous or corticocancellous), non-use of bone graft. Twelve studies met the inclusion criteria.

RESULTS: Seven of the 12 studies considered, described the use of a graft; the remaining five studies didn’t use any graft. Type of malunion was dorsal in most of the studies. The healing time was comparable using the graft or not (mean 12.5 wk), ranging from 7.5 to 16 wk. The mean disabilities of the arm, shoulder and hand score improvement was 23 points both in the studies that used the graft and in those not using the graft.

CONCLUSION: This review demonstrated that corrective osteotomy of extra-articular malunited fractures of the distal radius treated by volar locking plate does not necessarily require bone graft.

Keywords: Radial fracture, Osteotomy, Graft, Volar plate, Malunion

Core tip: The aim of this study was to review the current literature regarding corrective osteotomies in malunion of the distal radius to provide the best evidence of the rule of bone graft. The results of this review demonstrated that corrective osteotomy of extra-articular malunited fractures of the distal radius treated by volar locking plate does not necessarily require bone graft. Rate of union and functional outcomes were comparable.