Extension Osteotomy for Radiolunate Joint Osteoarthritis

Osteoarthritis (OA) of the radioscaphoid joint is the most common type of wrist OA; involvement of the radiolunate (RL) joint is comparatively less frequent. A 56-year-old man presented with right wrist pain, with radiographic findings of ulnar-plus variance, increased palmar tilt, and a subtle ulnar head osteophyte. Despite 7 years of conservative treatment, progressive OA of the RL joint developed. The patient opted for surgical intervention to relieve pain and preserve motion. A closed-wedged extension osteotomy of the distal radius was performed. At 1 year and 3 months after surgery, he had pain-free wrist motion, confirmed bony union, and preserved RL joint space. Extension osteotomy of the distal radius may be a viable surgical option for OA of the RL joint caused by bone morphology changes leading to increased palmar tilt.