Corrective osteotomy after malunited distal radius fractures.

Area of Science:

• Orthopedic surgery
• Traumatology
• Wrist biomechanics

Background:

• Posttraumatic wrist malunion and secondary dislocation lead to joint incongruency.
• Uncorrected malalignment exacerbates degenerative changes and chronic wrist pain.
• Accurate reduction and fixation are crucial for restoring wrist function.

Purpose of the Study:

• To highlight the importance of early correction for wrist joint incongruency.
• To present a technique for precise correction of malalignment.
• To define indications for cancellous bone grafting and staged procedures.

Main Methods:

• Utilizing fixed-angle devices for precise angular correction.
• Employing a palmar approach for plate pre-mounting.
• Considering cancellous bone grafting for larger bony defects.
• Advising a two-staged procedure for significant radius and ulna discrepancies in posttraumatic growth arrest.

Main Results:

• Premounting plates with desired correction angles ensures predictable and precise outcomes.
• Early intervention mitigates the risk of secondary osteoarthritis and persistent pain.
• Cancellous bone grafting is reserved for substantial bone defects, optimizing treatment.

Conclusions:

• Early and precise correction of posttraumatic wrist malalignment is essential.
• The described palmar approach with fixed-angle devices facilitates predictable results.
• Management strategies should be tailored to the extent of bony defects and growth discrepancies.