Jnl Wrist Surg 2018; 07(01): 084-088
DOI: 10.1055/s-0037-1603769
Case Report
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

A Posttraumatic Distal Radius Allograft: 10 Years Follow-Up

Giulio Lauri
1  Hand Surgery and Reconstructive Microsurgery Unit, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
,
Marco Biondi
2  Orthopaedic Clinic, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
,
Giuliana Roselli
3  Radiologia 1, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
,
Prospero Bigazzi
1  Hand Surgery and Reconstructive Microsurgery Unit, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
› Author Affiliations
Funding None.
Further Information

Publication History

04 February 2017

11 May 2017

Publication Date:
09 June 2017 (eFirst)

Abstract

Background Wrist osteoarthritis is a common disease often resulting from malunited fractures of the distal radius. The primary treatment purpose is to provide pain relief, while maintaining strength and mobility whenever possible. In a patient presenting a posttraumatic degeneration of the wrist, deciding which surgical technique, which joints to sacrifice and which to preserve is crucial to optimizing the outcome.

Case Description We describe a 10-year follow-up of an osteoarticular allograft of the distal radius proposed to treat an isolated distal radius posttraumatic degeneration. The patient was young and active. No or slight articular degeneration of the carpal rows was present. The surgical technique was based on a periarticular step-cut that allowed the preservation of the dorsal capsule and the maximum contact between the bone and the allograft.

Literature Review In the literature, the allograft of the radius is described as a solution to an oncologic problem. Considering a posttraumatic scenario other techniques are usually performed. However, compared with artificial interbody fusion devices and prosthetic implants, structural bone allograft retains an advantage in biologic performance. It has osteoconductive properties and is similar to native tissues providing a progressive incorporation by the host.

Clinical Relevance This surgical technique provide a metaphyseal step-cut able to ensure a secure stabilization and a wide contact surface between the allograft and the native bone. Integration of the allograft with good functional and radiological outcome seen after 10 years supports this technique.