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Orthopaedic Proceedings
Vol. 86-B, Issue SUPP_II | Pages 171 - 171
1 Feb 2004
Psychoyios VN Villanueva-Lòpez F Cuadros-Romero M Zambiakis Å Sekouris Í Fernández-Martín J Cañada-Oya S
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Introduction: Traumatic injury to a peripheral nerve with loss of continuity is a disabling condition due to denervation. Traditional treatment consists of nerve grafting with the consequence of unwanted side effects at the donor site (sural nerve).

Aims: To present an alternative treatment using two different biomaterials as implants bridging both ends of nerve.

Materials and Methods: The same hand surgeon treated twenty-one patients with traumatic laceration of less than 3 cm in the upper limb. Two different kind of flexible tubular sheaths were implanted: 18 patients with one and 3 with other. An independent observer assessed McKenney’s and two points discrimination tests for functional out come. We describe the surgical technique and report the full data.

Discussion: Polyglicolic acid is designed to create a conduct for axonal growth across a nerve gap making it unnecessary to carry out a nerve grafting. Its use is feasible in clean wounds less than 3 cm in length. It is technically easy to implant and reabsorbed within 3 months.

Conclusions: The satisfactory results in terms of functional recovery suggest the convenience of this technique to shorten the operating time and avoid donor site side effects.


Orthopaedic Proceedings
Vol. 86-B, Issue SUPP_II | Pages 166 - 166
1 Feb 2004
Psychoyios V Zambiakis Å Sekouris Í Villanueva-Lopez F Cuadros-Romero M
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Introduction: Common misconceptions about distal radius fractures result in undertreatment, particularly in active population.Loss of reduction can cause a symptomatic malunion. The aim of the study is to present the clinical consequences of a dorsally malunited distal radius fractures and the results of a corrective osteotomy for the treatment of this problem

Material: 18 patients with distal radius fractures healed in a dorsal angulation and a mean age of 39 years, treated with a corrective osteotomy. 13 patients had been treated by closed means, and 5 had undergone a earlier surgical procedures without success. 11 patients had a DISI instability of the wrist. 12 patients underwent a radius corrective osteotomy alone, 4 had a cpmined radial osteotomy amd ulnar shortening osteotomy, and 2 underwent only a Sauve-Kapandji procedure.

Results: The average follow up was 26 months. All the osteotomies healed. 15 of the deformities were corrected. 7 patients with DISI deformity were regained normal wrists whereas the rest 4 remained with DISI instability. One patient with normal wrist led to DISI instability postop.

Conclusion: Distal radius corrective osteotomy is a technically demanding operation, and by no means can guarantee a postop normal anatomy. Furthermore and despite the functional improvement it is unknown the remote consequences wth a ersidual DISI deformity.