Clin Orthop Surg.  2016 Jun;8(2):228-231. 10.4055/cios.2016.8.2.228.

Fixed Lunate Flexion Deformity in Distal Radius Fractures

• Lee S
• Yu JH
• Jeon SH

• KMID: 2412352
• DOI: http://doi.org/10.4055/cios.2016.8.2.228

Abstract

Carpal malalignments in malunion of distal radius fracture are considered as an adaptive response of the carpus to loss of normal architecture of the distal radius. This condition leads to mechanical overload, ligament attenuation and progressive dynamic instability around the wrist joint. Radial corrective osteotomy is suggested as a treatment option of carpal malalignment after distal radius malunion. In radiocarpal malalignment, the lunate is usually observed in flexion in contrast to its extension posture in the more common midcarpal malalignment. We report two cases of fixed lunate flexion deformity after a distal radius fracture, in which reduction and fixation of fresh fracture or corrective osteotomy of malunion were not successful. Arthritic changes were observed in the radiolunate joint on arthroscopy. Thus, fixed flexion deformity of the lunate might be associated with posttraumatic arthritic change in the radiolunate joint.

Keyword

Distal radius fracture; Lunate flexion; Radiocarpal arthritis

MeSH Terms

Adult
Arthroscopy
Female
Humans
*Lunate Bone/diagnostic imaging/pathology/physiopathology/surgery
Pregnancy
*Radius Fractures/diagnostic imaging/pathology/physiopathology/surgery
Range of Motion, Articular
Young Adult

Figure

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  Fig. 1 Initial (A), preoperative (B), and postoperative (C, D) radiographs of case 1 show the preoperative dorsal tilt of 27° (B), the postoperative volar tilt of 3° (C, D), and the flexion of the lunate after corrective osteotomy of the distal radius.

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  Fig. 2 Wrist arthroscopy of case 1 shows articular debris and fibrillation of distal radius (A) and cartilage denudation of the lunate (B).

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  Fig. 3 Preoperative (A) and immediate postoperative (B) radiographs of case 2 show normal alignment of the lunate. However, flexion of the lunate was evident at 6 weeks postoperatively (C) and persisted at the last follow-up (D).

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  Fig. 4 Arthroscopy of case 2 shows wear and irregularities of the articular surface of the radius (A) and the lunate (B).

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