[Winter sport injuries of the hand].
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Biomedical subjects
Publications and source records attributed to D L Fernandez.
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Corrective osteotomy is indicated in young manual workers with significant malalignment after fracture of the distal radius without associated degenerative changes in the wrist joint. Chronic pain, limited motion and impaired power can be avoided and the cosmetic appearance of the hand improved, by restoration of the functional anatomy of the wrist. The operation consists of an opening-wedge osteotomy at the fracture site, sometimes combined with resection of the distal ulna. The approach may be dorsal or volar. A small iliac cortico-cancellous bone graft is inserted at the osteotomy site. Fixation is by an AO-small fragment-T-plate allowing early functional after-treatment.
A full description of the different types of Smith fractures following Thomas classification is given, together with the guidelines of treatment of each type. Conservative treatment is usually sufficient for types I and III, provided that reduction is anatomic and stable. The indication for internal fixation is given for all type II and unstable type III fractures. An exact description of the volar buttressing technique with the AO-T-plate is presented.
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