Mugnai Raffaele, Tarallo Luigi, Lancellotti Enrico, Zambianchi Francesco, Di Giovine Ettore, Catani Fabio, Adani Roberto
Raffaele Mugnai, Luigi Tarallo, Enrico Lancellotti, Francesco Zambianchi, Ettore Di Giovine, Fabio Catani, Orthopedics and Traumatology Department, Modena Policlinic, University of Modena and Reggio Emilia, 41124 Modena, Italy.
World J Orthop. 2016 Feb 18;7(2):128-35. doi: 10.5312/wjo.v7.i2.128.
To review the current literature regarding corrective osteotomies to provide the best evidence of the rule of bone grafting.
Our MEDLINE literature search included 280 studies using the following key words "Malunited distal radius fracture" and 150 studies using key words "Corrective osteotomy of the distal radius". Inclusion criteria were: Malunited distal radial, extra articular fracture, volar locking plate, use of iliac bone graft (cancellous or corticocancellous), non-use of bone graft. Twelve studies met the inclusion criteria.
Seven of the 12 studies considered, described the use of a graft; the remaining five studies didn't use any graft. Type of malunion was dorsal in most of the studies. The healing time was comparable using the graft or not (mean 12.5 wk), ranging from 7.5 to 16 wk. The mean disabilities of the arm, shoulder and hand score improvement was 23 points both in the studies that used the graft and in those not using the graft.
This review demonstrated that corrective osteotomy of extra-articular malunited fractures of the distal radius treated by volar locking plate does not necessarily require bone graft.
回顾当前关于矫正截骨术的文献，以提供植骨原则的最佳证据。
我们在MEDLINE数据库中进行文献检索，使用关键词“桡骨远端骨折不愈合”检索到280项研究，使用关键词“桡骨远端矫正截骨术”检索到150项研究。纳入标准为：桡骨远端骨折不愈合、关节外骨折、掌侧锁定钢板、使用髂骨植骨（松质骨或皮质松质骨）、未使用植骨。12项研究符合纳入标准。
在纳入的12项研究中，7项描述了植骨的使用情况；其余5项研究未使用任何植骨。大多数研究中骨折不愈合的类型为背侧。使用植骨与未使用植骨的愈合时间相当（平均12.5周），范围为7.5至16周。使用植骨的研究和未使用植骨的研究中，手臂、肩部和手部功能障碍评分的平均改善值均为23分。
本综述表明，采用掌侧锁定钢板治疗桡骨远端关节外骨折不愈合的矫正截骨术不一定需要植骨。
