[A correction technic using an osteotomy-graft in chronic impaction of the radial socket, called "die punch"]

The central crush of the radial glena, so-called "Die-Punch", may be relatively easy to fix, when it is initially recognized. Unfortunately, it is often ignored, which compromises the future of the radio-carpal joint. When this "die-punch" is at the stage of malunion, the cartilage depression is very difficult to reach to. It is the goal of this described technique: through an antero-lateral way, making a sagittal osteotomy guided on a K-wire, aiming at the lateral limit of the crush; the lateral fragment comprising the radial styloide process is then turned like a door around a posterior hinge, opening the access to the medial bony cut, at the lower part of it, the depressed fragment is clearly visible. This fragment is lowered with a chisel of appropriate width, until it joins its proper level; then a fragment of cancellous bone taken in the upper part of the cut is crammed in the room above the "die-punch". The "door" is then closed and fixed with a screw, without any problem of consolidation, so as the rehabilitation may be initiated immediately. The practice of this procedure is till now limited to a few cases (two), but the results are very encouraging. This technique is worthy to be tried by other hand surgeons.