The team of authors presents a case of the patient who suffered an isolated unstable extra-articular distal ulnar fracture, the surgical treatment of which was affected by a postponed management in consequence of inadequate primary treatment. The primary non-operative treatment resulted in a complex malunion ad latus, ad axim and ad peripheriam. The malunion which led to a painful restricted range of motion of the forearm (59%), decreased hand grip strength and significant limitation of activities of daily living was surgically treated by a triplane corrective osteotomy at 11 months after injury. At 12 months after surgery, a complete ulnar bone union was observed, the patient showed no residual wrist pain, the range of motion of the injured forearm reached 97 % of the range of motion of the unaffected forearm (side), and the hand grip strength was 95% of the hand grip strength in contralateral limb. The treatment outcome can be assessed as very good based on the Quick DASH score. Displaced isolated distal ulnar fractures cause a change in the axial position of the distal end of the bone and can be associated with an injury to the stabilizers of the DRUJ. Thus, they can result in a limited range of motion of the forearm due to the impaired DRUJ biomechanics and development of early post-traumatic osteoarthritis of the DRUJ. The non-operative treatment is recommended only for stable and non-displaced fractures as well as fractures in which surgical treatment is contraindicated. Corrective osteotomy of the distal ulna is the method of choice in managing distal ulna malunion as a result of isolated distal ulnar shaft fractures in symptomatic patients. Good functional outcomes may be achieved if the anatomical position of DRUJ is restored. Key words:corrective osteotomy, distal ulnar fracture.

• MeSH
• čas zasáhnout při rozvinutí nemoci MeSH
• fraktury ulny komplikace   chirurgie   terapie   MeSH
• konzervativní terapie škodlivé účinky   MeSH
• lidé MeSH
• osteotomie metody   MeSH
• rozsah kloubních pohybů MeSH
• špatně zhojené fraktury etiologie   chirurgie   MeSH
• výsledek terapie MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

PURPOSE OF THE STUDY The purpose of our retrospective study is to evaluate 5-year functional and radiological outcomes in patients following corrective osteotomy of the distal radius and ulnar osteotomy for malposition after a distal radius fracture, to identify differences in the outcomes of corrective osteotomies depending on the type of the original fracture according to the AO classification, the grade of arthritis of radiocarpal (RC) joint, surgical approach and the way of stabilisation of the osteotomy. MATERIAL AND METHODS The followed-up group of 22 patients (8 men and 14 women) underwent osteotomy for malposition of distal radius in the period 2007-2011. The age of patients in the followed-up group ranged from 21 to 72 years, with the mean age of 51 years at the time of surgery. The indications for corrective osteotomy due to distal radius deformity were the following: functional limitation, pain and radiological parameters confirming the deformity. The opening wedge osteotomy of distal radius performed through volar or dorsal approach, isolated shortening osteotomy of ulna and a combination of both the methods were used. The observations included: the original type of fracture according to AO/OTA classification, functional outcomes - Disabilities of the Arm Shoulder and Hand (DASH) score, Mayo Wrist Score (MWS), range of motion, grade of wrist arthritis and specific complications. The follow-up period was 5 years. RESULTS Average results were obtained in the group of patients before/after the osteotomy: DASH score- 35/14, MWS- 54/77, flexion- 44°/64°, dorsiflexion- 48°/61°, supination- 75°/79°, pronation- 72°/83°, ulnar duction- 20°/23°, radial duction- 9°/16°, grip strength in percentage- 59%/83%. After osteotomy, a statistically significant increase was observed in flexion, dorsiflexion, supination, pronation, radial duction, ulnar duction, grip strength in percentage, MWS, while in the DASH score a statistically significant decrease was reported. Based on the statistical evaluation of differences in functional outcomes after osteotomy, in patients with type A and C original distal radius fractures no difference in range of motion parameters was found after osteotomy. As to the mean values, the flexion and dorsiflexion range of motion was greater by 10° in patients after extra-articular osteotomy for malposition following the type A original fracture as compared to the type C fracture. By measuring the Joint Space High (JSH) ratio, no statistically significant changes were found regarding the progression of arthrosis of the radiolunate and radioscaphoid part of the RC joint as against the arthrosis in patients up to 5 years after corrective osteotomy of the distal radius. In patients with distal radius malposition and RC joint grade 1-2 arthritis according to the Knirk and Jupiter classification, better functional outcomes were achieved than in the limited and total wrist arthrodesis. In our patients, at 5 years after osteotomy no worsening was observed of the existing wrist arthritis and no arthritis was newly diagnosed. Specific complications were found in 4 cases (18.2 %). In 2 patients after radial osteotomy from dorsal approach (extensor tendon irritation, rupture of the long extensor tendon of the thumb), removal of osteosynthesis material was necessary in both the patients. In one patient after the isolated ulnar shortening osteotomy, an intraoperative fissure of distal ulnar fragment was detected, which healed without any further complications. In one patient an iatrogenic fracture of anterior superior iliac spine was observed after harvesting the corticospongious graft from the ala of the ilium. DISCUSSION Corrective osteotomy is a well-established method for treating distal radius deformities following a fracture. Even at present, there are various opinions regarding the indications, contraindications, timing of the surgery, osteotomy technique and the need to use a bone graft. Limited or total wrist arthrodeses in the area of wrist arthrosis and deformities bring good results with respect to the pain relief, but a limited range of motion occurs mainly in younger patients. Bearing this in mind, in grade 1-2 wrist arthritis in patients with distal radius deformities, a better functional outcome can be achieved by osteotomy. By using dorsal or volar approach, comparable outcomes can be obtained, but with the dorsal approach there is higher frequency of complications and the need to remove the osteosynthesis material. CONCLUSIONS Corrective osteotomies resulted in an improved functional outcome in the treatment of deformities after a distal radius fracture. Apart from deformity correction, the treatment has been affected also by the RC joint arthritis. The study confirmed neither statistically significant differences in the osteotomy outcomes in patients with the original type A or type C distal radius fracture according to the AO classification, nor the statistical significance of the RC joint arthritis. Our results have proven better functional outcomes of deformity correction achieved by osteotomy in case of grade 1 and 2 arthritis than by the limited wrist arthrodesis. In patients showing arthritic changes, no progression was reported within five years after the osteotomy. Key words: distal radius fracture, distal radius deformity, osteotomy, functional results.

• MeSH
• fraktury vřetenní kosti * diagnóza   etiologie   chirurgie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• následné studie MeSH
• obnova funkce MeSH
• osteotomie * škodlivé účinky   metody   MeSH
• pooperační komplikace diagnóza   MeSH
• poranění zápěstí * komplikace   patofyziologie   MeSH
• radiografie MeSH
• radius * diagnostické zobrazování   zranění   chirurgie   MeSH
• rozsah kloubních pohybů MeSH
• špatně zhojené fraktury diagnóza   chirurgie   MeSH
• zápěstní kloub * diagnostické zobrazování   patofyziologie   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika MeSH

PURPOSE OF THE STUDY: The aim of the study was to retrospectively evaluate the treatment outcomes of displaced supracondylar humerus fractures, including potential complications, in children treated at the Department of Paediatric General Surgery, Orthopaedics and Trauma Surgery of the Faculty of Medicine in Brno between 2000 and 2011. MATERIAL AND METHODS: The study comprised 564 children, 321 (57%) boys and 243 (43%) girls, who were allocated to two groups according to the method of primary treatment. The average age at the time of injury was 6.8 years (range, 1 to 16). In group 1, all 499 patients were indicated for primary closed reduction and percutaneous osteosynthesis with crossed K-wires under general anaesthesia. In group 2, all 65 patients underwent closed reduction under general anaesthesia and immobilisation in a high plaster cast. The per cent failure of primary treatment requiring either repeat surgery or a change in treatment strategy was evaluated. The duration of follow-up ranged from 14 to 150 months. RESULTS: Open fractures were recorded in eight (1.4%) patients. Twenty-five (4.4%) children had further injury to the ipsilateral limb. Three (0.5%) patients underwent open reduction because it was not possible to achieve adequate reduction by the closed method. In group 1, percutaneous osteosynthesis was performed using two crossed K-wires in 484, three K-wires in 13 and four K-wires in two patients. Re-displacement of fracture fragments requiring repeat reduction and percutaneous osteosynthesis occurred in 10 (2%) patients. One patient had two re-operations. In group 2, the primary treatment failed in 13 (20%) children who needed repeat reduction and conversion to percutaneous osteosynthesis. The difference in the occurrence of failure between the two groups was significant (p<0.001). Nerve injury was recorded in 92 patients (16.3% of all children and 18% of those treated with percutaneous osteosynthesis). Neurosurgical intervention was necessary for injury to the ulnar nerve in five patients and to the radial nerve in one patient. Three children had vascular injury requiring vascular surgery. Two patients underwent corrective osteotomy of the distal humerus for cubitus varus deformity. Volkmann's contracture as a complication was not recorded. DISCUSSION: Minimally displaced fractures can be treated by closed reduction and plaster cast immobilisation but this method fails in up to 20% of cases. A poor result is related to the extent of dorsal displacement before reduction; on the other hand, degrees of flexion in a plaster cast have no effect. The most frequent technical errors resulting in re-displacement after primary osteosynthesis include incomplete reduction and primary fixation in displacement, or failure of both K-wires to pass through the opposite cortex or to fix both fragments firmly. A K-wire diameter smaller than 1.6 mm may also be a reason for failure. The main problem of the method of two crossed K-wires is a frequent injury to the ulnar nerve. CONCLUSIONS: Supracondylar humerus fracture is, regardless of advancements in therapy, an injury with an uncertain treatment outcome and a high percentage of complications. Since primary osteosynthesis failed in 20% of the patients treated by simple reduction under general anaesthesia and plaster cast immobilisation, for the patients requiring fracture reduction under general anaesthesia, the authors recommend one-stage primary treatment including K-wire transfixation. Re-displacement after primary osteosynthesis was always due to a technical error during the surgical procedure and can, therefore, be avoided by a precise operative technique.

• MeSH
• dítě MeSH
• fraktury humeru * diagnostické zobrazování   patofyziologie   chirurgie   MeSH
• interní fixátory MeSH
• lidé MeSH
• následné studie MeSH
• nervus radialis zranění   MeSH
• neurochirurgické výkony metody   MeSH
• osteotomie metody   MeSH
• pooperační komplikace * diagnóza   chirurgie   MeSH
• poranění cév * etiologie   chirurgie   MeSH
• poranění periferního nervu * etiologie   chirurgie   MeSH
• radiografie MeSH
• reoperace metody   MeSH
• retrospektivní studie MeSH
• špatně zhojené fraktury * diagnostické zobrazování   patofyziologie   chirurgie   MeSH
• vnitřní fixace fraktury * škodlivé účinky   přístrojové vybavení   metody   MeSH
• výkony cévní chirurgie metody   MeSH
• výsledek terapie MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika MeSH

BACKGROUND: Fractures of the medial clavicle third are rare injuries. Even in case of significant fracture displacement, their therapeutic management has been nonoperative. Recently, surgical intervention has become mandatory for displaced fractures types to prevent non-union and functional complaints, but the optimal operative strategy is being discussed controversially. CASE PRESENTATION: We describe the case of a 63-year-old male patient with a significantly displaced medial clavicle fracture after failed conservative treatment resulting in restricted, painful shoulder function. The patient underwent open reduction and osteosynthesis with an anatomically precontoured locking compression plate (LCP). One year after surgery the patient is free of complaints and has returned to his preinjury activity level without any functional restrictions. CONCLUSION: As a not yet reported operative approach, anatomically preshaped locking plating seems to be an effective fixation method for displaced fractures of the medial clavicle third. The operative management is described in detail and discussed with the current literature. Based on the presented case, we underline the statement that displaced medial clavicle fractures should be surgically addressed to avoid late damage.

• MeSH
• fraktury kostí * diagnostické zobrazování   chirurgie   MeSH
• hojení fraktur MeSH
• klíční kost * zranění   patologie   patofyziologie   chirurgie   MeSH
• kostní destičky * MeSH
• lidé středního věku MeSH
• lidé MeSH
• obnova funkce MeSH
• protézy - design metody   MeSH
• radiografie MeSH
• špatně zhojené fraktury diagnostické zobrazování   chirurgie   MeSH
• vnitřní fixace fraktury * přístrojové vybavení   metody   MeSH
• výsledek terapie MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH
• přehledy MeSH

PURPOSE OF THE STUDY: The aim of the study was to evaluate the outcomes of corrective osteotomy for malunited fractures of the distal radius, to assess the degree of correction or its loss, if it happened, after bone union, and to compare the clinical and radiographic results with the relevant literature reports. MATERIAL AND METHODS: In the period from September 2002 and October 2004, a total of 16 patients (six men and 10 women) underwent surgery for malunited fractures of the distal radius. The average patient age was 49.3 years, with a range of 23 to 73 years. For the sake of evaluation, records were made of patients' subjective feelings, objective measurements of motion range and muscle strength and exact measurements of relevant parameters on radiographs. Plain radiographs of the distal radius of both upper extremities in anteroposterior and lateral projections were made before and after surgery, and at final follow-up after osteotomy healing. The following parameters were measured: length of the radius, ulnar inclination angle and tilt of the distal articular surface of the radius. Because we evaluated our patients in retrospect, it was not always possible to find the exact values of motion range and muscle strength as they existed before surgery. Therefore, for comparison, we used the values obtained on the unhurt extremity. Corrective surgery included radius opening-wedge osteotomy with bone graft insertion and subsequent fixation with a 3.5-mm T plate. The final evaluation was based on the New York Orthopaedic Hospital Wrist Rating Scale. RESULTS The highest lengthening achieved by corrective osteotomy was 9 mm. The largest change in the ulnar inclination angle was 34 degrees. The best correction of a dorsal deformity was 24 degrees. The result evaluation was : 30 % excellent, 50 % good, and 20 % fair. DISCUSSION Corrective osteotomy of the distal radius with graft insertion is one of the options for the restoration of anatomical conditions following malunited fractures. The timing and technique of the surgical procedure were in agreement with the data reported in the literature, as well as the results achieved in this study. CONCLUSIONS: Corrective osteotomy and bone graft insertion are surgical procedures used for the treatment of malunited fractures of the distal radius. They are indicated in active younger patients with proven symptoms and correlating radiographic evidence. The surgery should be preceded by a thorough radiographic examination and pre-operative planning. Key words: distal radius fracture, bone malunion, corrective osteotomy.

• MeSH
• dospělí MeSH
• fraktury vřetenní kosti diagnostické zobrazování   chirurgie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• osteotomie * MeSH
• radiografie MeSH
• radius chirurgie   MeSH
• senioři MeSH
• špatně zhojené fraktury diagnostické zobrazování   chirurgie   MeSH
• transplantace kostí MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

PURPOSE OF THE STUDY Surgery for the nonunion or malunion of pelvic fractures is not common even at specialised departments. This article presents the authors experience with this procedure, completed with case studies and a review of relevant literature. MATERIAL AND METHODS From 1998 to 2007, a total of 359 patients underwent surgery for pelvic trauma. In the same period, eight surgeries on nonunions or malunions of the pelvis were performed, three in men and five in women. The average age of the patients was 37.3 years (range from 15 to 68). The primary treatment included conservative therapy (two patients), external fixation (three patients) and osteosynthesis of the anterior pelvic segment in another three patients. Reconstructive surgeries were always executed for nonunion or malunion or for both conditions together. Patients suffered most often from pain, limping, from the need of using crutches or leg shortening; no diffuculties occurred while sitting. Surgery for nonunion or malunion was performed at the average period of 29.3 months (range from 6 to 84) after injury. Surgical techniques and risks are described in detail. RESULTS Two patients suffer from persistent pain after surgery. In one patient, it is due to partial sacroiliac ankylosis with pathological mobility of the remaining part of the sacroiliac joint together with nonunion of the fractured dorsal part of the ilium. In the other one, pain comes from muscular dysbalance, as well as from chronic lesions in the sacroiliac joint and from scoliosis, despite the fact that the pelvis was successfully reconstructed 7 years after the initial injury. Four patients have no or only transient pain. In four patients limping disappeared after surgery; in two it is still persisting. One of these is the patient with partial sacroiliac joint ankylosis, while symphysis pubic diasthesis persists in the other. Leg length difference, sitting problems or other complaints following surgery are not observed. Four patients developed union detected radiologically, widening of the symphysis persists in one patient and sacroiliac joint problem in another one. Excellent results with anatomic integrity in all three x-ray projections were achieved in only two patients. Satisfactory outcome with a residual deformity of less than 1 cm of the vertical or posterior displacement or up to 15-degree rotation in any plane was achieved in three patients. A poor outcome involving more than 1-cm dislocation was found in one case. DISCUSION The most common cause of poorly healed pelvic fractures is a misdiagnosis of the primary injury and a subsequent conservative way of treatment. Injuries to the posterior pelvic segment are repeatedly underestimated. A frequent error in pelvic ring fracture therapy is that only the anterior pelvic segment is treated surgically, often with only a simple external fixator inserted in the iliac crests. In addition, the treatment strategy is often decided on in hospitals whose surgeons have not enough in pelvic trauma surgery. The most frequent complaints associated with an inadequate treatment are pain, walking problems and limping. Sitting can be difficult in some patients. Urinary bladder can be compressed with the result of frequent and urgent miction, and vaginal compression could bring about dyspareunia. Additionally, pelvic deformations in women can aggravate delivery. Cosmetic changes due to a prominent sacrum, a prominent greater trochanter or distal spine scoliosis are also of concern. The method of an accurate measurement of anatomic alterations of the pelvis is presented. CONCLUSIONS Early surgery of the pelvic trauma enables an adequate restoration of pelvic anatomy and provides conditions for good and reliable stability of both the posterior and anterior pelvic segments. Late repairs of nonunions or malunions are demanding and associated with a high risk of serious complications, often with long-term sequelae. Key words: pelvic fracture, malunion, nonunion.

• MeSH
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• nezhojené fraktury diagnostické zobrazování   chirurgie   MeSH
• pánevní kosti diagnostické zobrazování   zranění   chirurgie   MeSH
• radiografie MeSH
• senioři MeSH
• špatně zhojené fraktury diagnostické zobrazování   chirurgie   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

PURPOSE OF THE STUDY: This is a cross section retrospective study which shows undertaken in order to determine the frequency and degree of postoperative alterations in size of cortico-cancellous autografts used in corrective osteotomies of the distal radius. PATIENTS AND METHOD: In the period from 1987 to 2002, 50 patients (21 females and 29 males, mean age 38 years, range 18-64, were treated with corrective osteotomy, bone grafting and internal fixation after mal-united Colles' fracture. The patients were followed up from 6 months to 5 years (average 15 months). Heights of volar, ulnar, dorsal and radial sides of the graft were determined from radiographs (preoperative, immediately after the surgery and at the late follow-up examination) according to the BIZCAD method and put into the computer program, which compared them in three dimensions. RESULTS: In sixteen patients (32 %) one or more sides of the graft decreased in height during the postoperative period by more than three millimeters. In five cases there was a complete resorption of the implanted graft. In the other thirty-four cases, an average decrease in all sides of graft was statistically significant. Unequal decrease led to an increase of volar inclination angle of the distal articular surface of the radius, averaging 3 degrees. Influence of age on the diminution of the graft size was found. More distally placed grafts had less incidence of significant resorption. A correlation between initial height of the side of the graft and its alterations was also found (r=0.49, p<0.001). CONCLUSION: Postoperative changes in the size of graft are frequent and represent a serious obstacle to the success of corrective osteotomies. We recommend that: 1. the use of a the higher bone graft for elongating of the radius, however with a greater chance of resorption; the alternative method of ulna shortening should be considered; 2. the osteotomy line and the grafts should be placed more distally to decrease the risk of resorption; 3. if osteotomy can't be performed distally enough, postoperative immobilization for about three weeks should be considered.

• MeSH
• dospělí MeSH
• fraktury vřetenní kosti chirurgie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• osteotomie * MeSH
• radius chirurgie   MeSH
• špatně zhojené fraktury chirurgie   MeSH
• transplantace kostí * MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

OBJECTIVE: To evaluate the results of valgus intertrochanteric osteotomy for varus nonunion and malunion of trochanteric fractures. SETTING: University hospital. DESIGN: Retrospective clinical study. PATIENTS: Fifteen patients (age range 29-84 years) with varus malunion (11 cases) or varus nonunion (4 cases). Indication for surgery was nonunion or varus malunion with limb shortening greater than 2 cm associated with limp, abductor muscle insufficiency, hip pain, and back pain. INTERVENTION: The patients were treated by a valgus intertrochanteric osteotomy fixed with a 120 degrees double-angled blade plate. RESULTS: Average follow-up was 5.5 years (range 2-10 years). Fourteen patients healed without complications: 12 patients within 4 months; 2 delayed unions within 6 months. One patient required revision surgery for a loss of fixation due to a fall 6 weeks after surgery. This osteotomy also healed. Average lengthening achieved by osteotomy was 2 cm (range 1-5 cm). In all patients, the resulting range of flexion in the hip joint was greater than 90 degrees, Harris hip score before surgery was 73 points (range 61-83), and after surgery 92 points (range 76-98). Osteoarthritis or avascular necrosis of the femoral head did not develop in any of the cases. CONCLUSION: Valgus intertrochanteric osteotomy is an effective procedure that reliably restores hip function in trochanteric malunion or nonunion.

• MeSH
• dospělí MeSH
• fraktury kyčle diagnostické zobrazování   chirurgie   MeSH
• kostní destičky MeSH
• lidé středního věku MeSH
• lidé MeSH
• nezhojené fraktury diagnostické zobrazování   chirurgie   MeSH
• osteotomie metody   MeSH
• radiografie MeSH
• retrospektivní studie MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• špatně zhojené fraktury diagnostické zobrazování   chirurgie   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

PURPOSE OF THE STUDY: Mal-union of distal radius fractures cause functional limitation and progressive degenerative changes of the wrist. The authors evaluate both radiograph and functional outcomes in a group of patients with a post-traumatic deformation of the distal radius treated by corrective osteotomy and fixation by a newly developed T-plate. MATERIAL: A retrospective evaluation covered a group of 13 patients of the average age of 51 years (range, 35-60 years) operated on in 2001 for post-trauma symptomatic mal-union of the distal radius of the Colles type. The group included only patients in which a new implant was used. The time interval between the primary fracture and corrective osteotomy was on average 11 months. METHODS: Corrective osteotomy for Colles deformations was performed in all patients from the dorsal approach with the application of a cortico-cancellous bone graft. Stabilisation was performed by the mentioned plate. Radiograph and functional outcomes were evaluated statistically. RESULTS: The radiographic evaluation proved the restoration of the normal anatomic relationship between the distal radius and ulna as well as statistically significant improvement of the function of the hand as concerns the range of motion and muscular strength Except for one patient, all involved evaluated the outcome as a subjective improvement. DISCUSSION: Corrective osteotomy of the distal radius is a standard surgery performed routinely by plate fixation with the application of a cortico-cancellous bone graft. Despite a perfect coverage of the issues relating to potential consequences resulting from non-anatomic position of the articular surface of the distal radius, this surgery was not very frequent in the past. Nevertheless, recently, there is a growing number of works in the literature dealing with corrective osteotomies for mal-union of the distal radius after fractures not only for the Colles but also Smith type. CONCLUSIONS: Treatment of deformation of the distal radius is a rewarding procedure which brings the patients a significant improvement of the function of the hand. The implant used by the authors proved useful for a plate fixation on the distal radius.

• MeSH
• dospělí MeSH
• fraktury vřetenní kosti chirurgie   MeSH
• kostní destičky * MeSH
• lidé středního věku MeSH
• lidé MeSH
• osteotomie * MeSH
• radius chirurgie   MeSH
• špatně zhojené fraktury chirurgie   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH

• Klíčová slova
• ANKLE/fracture and dislocation *, FRACTURES, UNUNITED/surgery *,
• MeSH
• dítě MeSH
• fraktury kostí * MeSH
• hlezenní kloub * MeSH
• kojenec MeSH
• kotník * MeSH
• lidé MeSH
• nezhojené fraktury chirurgie   MeSH
• špatně zhojené fraktury * MeSH
• Check Tag
• dítě MeSH
• kojenec MeSH
• lidé MeSH
• Publikační typ
• časopisecké články MeSH