Malunion is the most common complication of the distal radius with many modalities of treatment available for such a problem. The use of bone grafting after an osteotomy is still recommended by most authors. We hypothesised that bone grafting is not required; fixing the corrected construct with a volar locked plate helps maintain the alignment, while metaphyseal defect fills by itself. Prospectively, we performed the procedure on 30 malunited dorsally-angulated radii using fixed angle volar locked plates without bone grafting. At the final follow-up, 22 wrists were available. Radiological evidence of union, correction of the deformity, clinical and functional improvement was achieved in all cases. Without the use of bone grafting, corrective open wedge osteotomy fixed by a volar locked plate provides a high rate of union and satisfactory functional outcomes.

Introduction: Common misconceptions about distal radius fractures result in undertreatment, particularly in active population.Loss of reduction can cause a symptomatic malunion. The aim of the study is to present the clinical consequences of a dorsally malunited distal radius fractures and the results of a corrective osteotomy for the treatment of this problem

Material: 18 patients with distal radius fractures healed in a dorsal angulation and a mean age of 39 years, treated with a corrective osteotomy. 13 patients had been treated by closed means, and 5 had undergone a earlier surgical procedures without success. 11 patients had a DISI instability of the wrist. 12 patients underwent a radius corrective osteotomy alone, 4 had a cpmined radial osteotomy amd ulnar shortening osteotomy, and 2 underwent only a Sauve-Kapandji procedure.

Results: The average follow up was 26 months. All the osteotomies healed. 15 of the deformities were corrected. 7 patients with DISI deformity were regained normal wrists whereas the rest 4 remained with DISI instability. One patient with normal wrist led to DISI instability postop.

Conclusion: Distal radius corrective osteotomy is a technically demanding operation, and by no means can guarantee a postop normal anatomy. Furthermore and despite the functional improvement it is unknown the remote consequences wth a ersidual DISI deformity.