J Korean Orthop Assoc.  2011 Dec;46(6):533-538.

Successful Treatment of Failed Ulnar Osteotomy by Concurrent Radial Osteotomy in a Forearm Malunion

• Gong HS
• Lee SJ
• Lee YH
• Baek GH

Abstract

We present a patient with malunion of the ulna and radius, who experienced 2 consecutive healing failures after osteotomy of the ulnar malunion only. The purpose of the surgery was for cosmetic reasons. Healing was fi nally obtained when a seemingly minimal malunion of the radius was corrected as well. This case suggests concurrent correction of both bone forearm malunion may be required to ensure satisfactory healing.

Keyword

malunion; osteotomy; forearm bone

MeSH Terms

Cosmetics
Dietary Sucrose
Forearm
Humans
Osteotomy
Radius
Ulna
Cosmetics
Dietary Sucrose

Figure

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  Figure 1 The patient had malunion of the right both forearm bones. The ulna had 45 degrees of posterolateral angulation and the radius had 15 degrees of posterior angulation. The initial radiographs at the time of injury were unavailable.

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  Figure 2 At a local hospital, corrective osteotomy of the ulna was performed using a 3.5 mm reconstruction plate and screws, leaving the radius uncorrected.

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  Figure 3 Ten weeks postoperatively, the patient felt a sudden pain at the osteotomy site and the radiograph revealed a broken plate and fracture of the osteotomy.

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  Figure 4 Reoperation was performed at the same local hospital for the nonunited ulna using another longer reconstruction plate and screws and autogenous iliac bone graft.

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  Figure 5 Ten weeks after the second operation, the patient felt a sudden pain again at the operation site and the radiograph showed a breakage of the plate.

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  Figure 6 Photographs showing forearm rotations prior to the last operation. The patient had 45 degrees of supination and 60 degrees of pronation in the involved side, and 90 degrees of supination and 70 degrees of pronation at the opposite side.

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  Figure 7 Radiograph taken 12 months after the last operation, showing union of the osteotomies in the radius and the ulna.

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  Figure 8 Photographs showing forearm rotations one year after the operation. The patient had 70 degrees of supination and 60 degrees of pronation in the involved side.

Reference

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