Distal radius isoelastic resurfacing prosthesis – a preliminary report

Background

Here, we present a preliminary case series of unicompartmentalisoelastic resurfacing prosthesis of distal radius to treat comminuted articular fractures of osteoporotic elderly patients.

Materials and methods

Our study included 12 patients, mean age 76-year-old, who presented which a comminuted osteoporotic distal radius fracture. Because of the severity of injury and poor bone quality + osteosynthesis was not deemed to be a good option.

Description of technique

The surgery was performed through a dorsal approach. The subchondral bone of the entire distal radial articular was excised and a unicompartmental prosthesis was applied.

Results

The average follow-up was 32 months. Patients reported an average of pain on a VAS score of 2.8/10. The QuickDASH was 37.4/100. The grip strength was in neutral 49.9%, in supination 59.0%, in pronation 56.2% of the contralateral side respectively. The wrist range of motion in flexion and extension were 56.1% and 79.3%, in supination and pronation 87.7% and 91.0%, respectively compared to the contralateral side. Four postoperative complications were noted. Two patients experienced a complex regional pain syndrome type II + these resolved spontaneously. One patient experienced distal radio-ulnar joint stiffness, this improved after an ulna head resection. Finally, one patient required revision surgery after a secondary traumatic fracture. This was revised with another Unicompartmental prosthesis. Radiographically+ the average volar tilt was 9.8° + the average of radial inclination was 11.6°.

Conclusion

The concept of a unicompartmental isoelastic resurfacing prosthesis offers a promising option for the treatment of comminuted, osteoporotic distal radius articular fractures of elderly patients.