PMC4603322_01
Case report 1 (preoperative and surgical procedures): (a) initial CT images in three levels; (b) AP and lateral radiographs after closed reduction and external fixation; (c) intraoperative clinical photo and AP fluoroscopy after removal of external fixateur, percutaneous pinning, and USO (arrow) showing no ulnar-positive variance (points); note the displaced ulnar styloid base fracture; (d) intraoperative clinical photo and AP fluoroscopy after Maestro WRS insertion showing correct position of implant; note the scaphoid augment of the carpal component after complete scaphoid excision (arrow).
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fig2
A 56-year-old right-handed male patient with adequate bone stock presented with a highly comminuted intra-articular DRF right after a high-energy fall from a height of three meters (Figure 2(a)). After closed reduction and external fixation (CREF), the anterior-posterior (AP) and lateral radiographs showed unchanged multiplanar displacement with complete DRUJ incongruity due to a pronounced radial shortening of 7 mm, severely destroyed radial articular surface, and excessive substantial dorsal tilt of 40  (Figure 2(b)). Intraoperatively, there was no evidence of ulnar-positive variance (Figure 2(c)). Four weeks after injury, the noncemented angle-stable Maestro WRS was inserted (Figure 2(d)).
Case report 1 (1-year follow-up): (a) AP radiographs with terminal range of motion: no signs of loosening of either implant and no impingement or impaction; note the union of USO; (b) lateral radiographs with terminal range of motion: no subluxation of distal ulna (arrows); (c) clinical photo with supination-pronation arc on both sides.
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fig3
At the 1-year follow-up, there was no change in position of both implants without any signs of loosening, no impingement, a complete union of USO, and no subluxation of the distal ulna (Figures 3(a)-3(b)). The forearm supination (90 )-pronation (80 ) arc was 94,4% of the opposite wrist (Figure 3(c)).
PMC4603322_02
Case report 2 (preoperative and surgical procedures): (a) initial AP and lateral radiographs; (b) coronary and sagittal CT images after removal of external fixateur and percutaneous pinning demonstrating a step-off in the radial articular surface of 3 mm and widened scapholunate gap (line) with midcarpal OA (arrow); (c) intraoperative clinical photo after Maestro WRS insertion by using a scaphoid augment of the carpal component after complete scaphoid excision (arrow) and resected ulnar head (arrow); (d) intraoperative AP and lateral fluoroscopy showing correct position of implant and the leakage of cement from one fixateur pin-hole (arrows).
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fig4
An 84-year-old right-handed female patient with poor osteoporotic bone stock presented with a highly comminuted intra-articular DRF right including radial shortening of 5 mm after a low-energy fall on the ground floor (Figure 4(a)). After that, the computed tomography (CT) images showed severely destroyed radial metaphysis with radial translation, a step-off in the articular surface of 3 mm, and preexisting SLAC II (Figure 4(b)). Four weeks after injury, insertion of the angle-stable Maestro WRS with cementing of radial component combined with ulnar head resection was performed (Figure 4(c)). Some cement leaked through one fixateur pin-hole at the distal radial diaphysis (Figure 4(d)); however, this did not cause functional irritation of the interosseous membrane.
Case report 2 (1-year follow-up): (a) AP radiographs with terminal range of motion: no signs of loosening of either implant and no radioulnar impingement; (b) lateral radiographs with terminal range of motion: no subluxation of distal ulna stump (arrows); (c) clinical photo with supination-pronation arc on both sides.
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fig5
At the 1-year follow-up, there was no change in position of both implants without any signs of loosening, no impingement, and no subluxation of the distal ulna (Figures 5(a)-5(b)). The forearm supination (90 )-pronation (80 ) arc was 94,4% of the opposite wrist (Figure 5(c)).