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. 2024 Apr 16;10(9):e29570.
doi: 10.1016/j.heliyon.2024.e29570. eCollection 2024 May 15.

Forearm rotation improves after corrective osteotomy in patients with symptomatic distal radius malunion

E M van Es  1 , M Dijkhof  1 , J S Souer  2 , F J van Ewijk  3 , L Hoogendam  4 , H P Slijper  2 , R W Selles  4   5 , J W Colaris  1 ; Hand-Wrist Study Group
Collaborators, Affiliations

Forearm rotation improves after corrective osteotomy in patients with symptomatic distal radius malunion

E M van Es et al. Heliyon. .

Abstract

Objectives: Distal radius malunion can result in pain and functional complaints. One of the functional problems that can affect daily life is impaired forearm rotation. The primary aim of this study was to investigate the effect of corrective osteotomy for distal radius malunion on forearm rotation at 12 months after surgery. We secondarily studied the effect on grip strength, radiological measurements, and patient-reported outcome measurements (PROMs).

Patients and methods: This cohort study analysed prospectively collected data of adult patients with symptomatic distal radius malunion. All patients underwent corrective osteotomy for malunion and were followed for 1 year. We measured forearm rotation (pronation and supination) and grip strength and analysed radiographs. PROMs consisted of the Patient-Rated Hand/Wrist Evaluation (PRWHE) questionnaire, Visual Analogue Scale for pain, and satisfaction with hand function.

Results: Preoperative total forearm rotation was 112° (SD: 34°), of which supination of 49° (SD: 25°) was more impaired than pronation of 63° (SD: 17°). Twelve months after surgery, an unpaired Student's t-test showed a significant improvement of total forearm rotation to 142° (SD: 17°) (p < 0.05). Pronation improved to 72° (SD: 10°), and supination to 69° (SD: 13°) (p < 0.05). Grip strength, PROMs, as well as inclination and volar tilt on radiographs improved significantly during the first year after surgery (p < 0.05).

Conclusion: In patients with reduced forearm rotation due to distal radius malunion, corrective osteotomy is an effective treatment that significantly improves forearm rotation. In addition, this intervention improves grip strength, the PRWHE-score, pain, and satisfaction with hand function.

Keywords: Distal radius malunion; Forearm rotation; Patient-reported outcome measurements; Range of motion.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Inclusion flowchart of the study. Patients who were followed up for 12 months months in terms of pronation and supination were included in the primary analyses.
Fig. 2
Fig. 2
Forearm rotation at baseline and 3 and 12 months after surgery from the affected and contralateral sides. Boxes display the mean pronation (above the horizontal line) and supination (below the horizontal line). Whiskers display standard deviations.
Fig. 3
Fig. 3
Forearm rotation is divided into quartiles. The first (blue) indicates the worst quartile, while the fourth (yellow) illustrates the best quartile of baseline rotation. Markers display mean forearm rotation; error bars display standard deviations.
Fig. 4
Fig. 4
Patient-rated Wrist/Hand Evaluation (PRWHE) scores at baseline and 6 weeks, and 3, 6, and 12 months after surgery. Markers display mean scores; error bars display standard deviations.
See this image and copyright information in PMC

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