Treatment for the Malunion of the Distal Radius

Cho, Hyoun Oh; Kwak, Kyoung Duck; Cho, Sung Do; Ryoo, Cheol Soo; Jung, Woo Keun

Abstract

Malunited fractures of the distal radius may result in adequate function of the wrist with absence of pain in elderly patients. However, posttraumatic dedormity in younger, active patients is less well toterated, especially in those engaged in heavy manual work or who require a normal range of motion of the wrist. surgical correction of the malunion of the distal radius should be considered for this group of patients. Operation for the malunited fractures of the distal radius was performed in ten cases during the periods between January, 1990 and December, 1993, who were followed for an average of 15 months.The procedures included radial osteotomy(RO) in four malunions of short duration, radial osteotomy with ulnar shortening (RO & US) in these malunions of long duration and ulnar shortening(US) in three cases. We reviewed these cases retrospectively with respect to the clinical findings(pain, grip strength, range of motion of the wrist) and radiograpic changes(volar tilt, radial articular inclination and radiul shortening). Symptoms(radioulnar or radiocarpal pain) were improved in all cases. By compairing with the opposite sides, resedual loss of grip strength was 35% in RO group, 40% in RO & US and 31% in & US group. Residual loss of motion in flexion and extension or in deviation was similar in all groups, whill loss in rotation was less in RO or RO & US group than in US group. Inclination of the radial articular surface (radial inclination and volar tilt) was restored up to the degree similar to the opposite wrist in RO or US group, while was not in US group. Radial length was restored up to the dgegrees similar to the opposite wrist in all groups. The overall results were good or very good in five among the seven cases of RO group(with or without ulnar shortening), while good only in one among the cases of US group.