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Immediate Mobilisation Following Corrective Osteotomy of Distal Radius Malunions with Cancellous Graft and Volar Fixed Angle Plates

From the Hand and Wrist Center of Houston, Department of Orthopaedic Surgery, University of Texas, Houston, USA

Correspondence: Mark Henry, MD, Hand and Wrist Center of Houston, Department of Orthopaedic Surgery, University of Texas, 1200 Binz #1200, Houston, TX 77004, USA. Tel.: +1 713 333 4477; fax: +1 713 333 4478 E-mail:mhenry{at}houstonhand.com

The purpose of the study was to examine the reliability with which a specific technique of corrective osteotomy of malunions of the distal radius combined with early mobilisation could both restore the normal anatomic parameters of the radius and achieve a functional range of motion with good strength. Corrective osteotomy of the distal radius was performed through a volar approach using a fixed angle volar plate and cancellous bone graft from the iliac crest in 19 patients of mean age 50 years with initial malunions with a mean dorsal tilt of 36° and 7 mm of ulnar variance. An immediate mobilisation programme was started. All healed at a mean of less than 12 weeks (including two heavy smoking patients who required repeat cancellous bone grafting to achieve final union) to achieve a total arc of wrist motion around 120°, forearm rotation of 158° and grip strength which was 80% of contralateral. This treatment strategy was judged to be straightforward and effective.

Key Words: distal radius • malunion • osteotomy • bone graft • rehabilitation

Journal of Hand Surgery (European Volume), Vol. 32, No. 1, 88-92 (2007)
DOI: 10.1016/j.jhsb.2006.09.002


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