Correction of post-traumatic wrist deformity in adults by osteotomy, bone-grafting, and internal fixation

A corrective osteotomy for post-traumatic malalignment of the distal end of the radius was performed in twenty patients who were followed for an average of 3.6 years. The indications for correction were based on age, degree of deformity, limitation of function, pain, and appearance of the wrist. The procedure included an opening-wedge metaphyseal osteotomy combined with insertion of a graft and rigid internal fixation with a plate and screws to permit early motion. Depending on the direction of the angulation, a dorsal or volar approach was employed to guarantee a buttressing effect of the plate. The procedure gave satisfactory results when there were no degenerative changes in the radiocarpal or intercarpal joints and when the preoperative range of motion of the wrist was adequate. The results were graded as excellent in five patients, good in ten, fair in four, and poor in one.