Early Correction of Distal Radius Partial Articular Malunion Leads to Good Long-term Functional Recovery at Mean Follow-up of 4 Years

Abstract

Based on these findings, we recommend that early corrective osteotomies should be considered in young patients with intra-articular distal radius malunions before considering salvage procedures such as partial or complete wrist arthrodesis.

Open reduction through original fracture line and fixation with locking plate is a feasible approach for extra-articular distal radius fracture malunion

“…[ 7 ] Recently, corrective osteotomy for radius is an effective and classical treatment for DRF malunions. [ 8 , 10 ] Earlier, an opening wedge corrective osteotomy was widely used, which was via a dorsal approach followed by dorsal buttress plate fixation. [ 16 ] Open wedge osteotomy for radius could be performed with oscillating saw and osteotomes, and fixed with plate through a volar approach for Colles type fracture and a dorsal approach for Smith type fracture or a combined approach,[ 10 , 17 , 18 ] in which bone grafting for defect is required.…”

Reconstruction of intraarticular distal radius malunion with 3D printed guide and arthroscopic assisted intraarticular osteotomy

“…The right time for surgery is as soon as possible as long as the bones are still in good condition and the wrist function is still adequate. In general, 5–8 weeks after fracture is a suitable time when it is still possible to make corrections easily and without a bone graft [6] . After 4–6 months from the onset of the fracture, correction becomes more difficult as callus remodeling has occurred [7] .…”

Best Approaches in Distal Radius Fracture Malunions

“…Furthermore, one study showed that total disability is decreased and patients return to work earlier than those corrected at later stages [2]. After 4 to 6 months of healing, the callus is remodeled and correction becomes much more difficult and increases morbidity for the patient [3].…”

“…For symptomatic patients for whom osteotomy is indicated, the timing of intervention is controversial, but there is some evidence that intervention as early as 6 weeks may be beneficial [2,3]. Regardless of timing, the goal is to restore both radiocarpal and distal radioulnar joint (DRUJ) congruence to improve pain and function and prevent future arthritis [4].…”