[Correction of distal radial malunion by forward-sliding osteotomy. 3 case reports]

The "forward-sliding autograft" osteotomy is designed for the correction of malposition of the distal radius following distal radius fracture of which more than 70% (of 122 fractures) appear to unite with a dorsal tilt. The osteotomy technique described seems to be effective, maintaining identical length of both arms, and only needs local anesthesia. A local autologous graft is used instead of the iliac graft. Only minimal internal fixation material is required and removal of metal is not necessary. The dorsal approach is safe and free of nerve endings. The procedure is ideal for outpatient surgery and can be performed in a one day surgery center, ie on an outpatient basis. Osteopororis appears to have no effect on the results. However the technique is demanding and preoperative planning is mandatory. The surgeon should be familiar with the use of the external fixator in the case of secondary instability.