Abstract
Background Wrist osteoarthritis is a common disease often resulting from malunited fractures
of the distal radius. The primary treatment purpose is to provide pain relief, while
maintaining strength and mobility whenever possible. In a patient presenting a posttraumatic
degeneration of the wrist, deciding which surgical technique, which joints to sacrifice
and which to preserve is crucial to optimizing the outcome.
Case Description We describe a 10-year follow-up of an osteoarticular allograft of the distal radius
proposed to treat an isolated distal radius posttraumatic degeneration. The patient
was young and active. No or slight articular degeneration of the carpal rows was present.
The surgical technique was based on a periarticular step-cut that allowed the preservation
of the dorsal capsule and the maximum contact between the bone and the allograft.
Literature Review In the literature, the allograft of the radius is described as a solution to an oncologic
problem. Considering a posttraumatic scenario other techniques are usually performed.
However, compared with artificial interbody fusion devices and prosthetic implants,
structural bone allograft retains an advantage in biologic performance. It has osteoconductive
properties and is similar to native tissues providing a progressive incorporation
by the host.
Clinical Relevance This surgical technique provide a metaphyseal step-cut able to ensure a secure stabilization
and a wide contact surface between the allograft and the native bone. Integration
of the allograft with good functional and radiological outcome seen after 10 years
supports this technique.
Keywords
distal radius allograft - wrist arthritis - distal radius degeneration - distal radius
fracture - radioscapholunate
