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Combined radial closing-wedge osteotomy and ulnar shortening osteotomy for distal radius malunion
Arnaud Walch1, Sabine Pillot1, Thais Galissard2
1Hôpital Edouard Herriot, 5 place d'Arsonval, 69003 Lyon, France.
Purpose:
Distal radius malunion alters wrist biomechanics, leading to pain, stiffness, and functional impairment. Various corrective osteotomy techniques exist. The aim of this study was to evaluate the functional outcomes of a combined radial closing-wedge osteotomy and ulnar shortening osteotomy in the treatment of distal radius malunions.
Materials And Methods:
We retrospectively reviewed 20 patients who underwent combined radial closing-wedge osteotomy and ulnar shortening osteotomy for symptomatic distal radius malunions. Functional outcomes, grip strength, range of motion, and radiographic parameters were analyzed.
Results:
Surgery significantly improved supination (20°-80°), flexion (40°-60°), extension (50°-65°), and grip strength (12 kg-22 kg). Ulnar variance correction was achieved. Complications occurred in four cases, with three requiring revision surgery.
Discussion:
Combined radial closing-wedge osteotomy and ulnar shortening osteotomy effectively restores wrist function while avoiding graft-related complications. This approach provides an alternative to opening-wedge osteotomies for distal radius malunions.
Level Of Evidence:
IV.
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