Malunited Fractures

A novel surgical approach for treating distal radial extraarticular malunion: Oblique osteotomy with buttress plate stabilization

“…Abnormal ulnar variance, volar tilt angle of radial articulation, and radial inclination were measured (Figure 1 Journal of Orthopaedic Surgery 25 (2) finger functions associated with at least one of unacceptable radiographic criteria (ulnar variance м5 mm, volar tilt angle мÀ10 , or radial inclination <15 ). 4,5 Inclusion criteria of this study were all distal radial extraarticular fractures longer than 6 weeks, abnormal wrist and finger functions, and unacceptable radiographic criteria. Exclusion criteria were those malunions not treated by the described surgical technique.…”

“…19 A malunion was defined as a fracture being healed in unacceptable radiographic criteria. [4][5][6] The wrist function was evaluated by Modified Mayo Wrist Score (MMWS) and Disability of Arm, Shoulder and Hand (DASH) Score. 20,21 The former was executed by the surgeon and the latter by patient himself.…”

“…3 Minimally displaced intraarticular or most extraarticular fractures of the distal radius normally are treated by closed reduction with stable immobilization. 1,4,5 The function outcome of the wrist is normally satisfactory.…”

“…However, some patients may undergo inadequate treatment and fractures become malunions. [4][5][6] The wrist function may be immediately compromised or potentially deteriorated progressively. Intraarticular malunions generally cannot be treated predictively and the outcomes are uncontrollable.…”

“…11 An acceptable alignment of distal radial extraarticular fractures has been roughly reported. 4,5,12,13 In principle, the collapsed radius requires to be lengthened. Concomitantly, the three-dimensional frame requires to be restored.…”