Abstract
Purpose: The retrospective evaluation of long-term results after reconstructive radial osteotomy for mal-united distal radius fractures.
Material-Method: Twenty-eight patients (21 male and 7 female, average aged 46 years) with 23 dorsal and 5 palmar angulated malunited distal radius fractures were operatively treated during 1994–2002 in our department. The main indications were pain and functional impairment. Dorsal or palmar approach was used in proportion to the site of angulation. The preoperative average radial inclination, radial length and volar or dorsal tilt were 13.5 degrees, 6.3 mm and 23.5 degrees respectively. An open wedge radial osteotomy followed by interposition of trapezoidal iliac crest bone graft and fixation with plate ands crews was performed in all patients four months at least after the initial surgery. An ulnar leveling procedure was considered necessary in 2 patients.
Results: All patients were available in the last follow up evaluation (mean 3.7 years). The functional result according to Mayo wrist score was rated as very good in 15 patients, good in 7 and poor in 6. The average improvement in radial inclination was 14 degrees, in radial length 6.5 mm and in volar or dorsal tilt 21 degrees. The complication rate was 22.7%, including 2 material failures, 1 extensor pollicis longus rupture, 1 nonunion and 3 recurrences of the deformity.
Conclusion: Surgical reconstruction for malunion is technically demanding and may not completely restore the anatomy. Patient satisfaction, however, in terms of increased function, decreased pain and decreased deformity is sufficient high to warrant reconstructive treatment.
Theses abstracts were prepared by Professor Roger Lemaire. Correspondence should be addressed to EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.
