RECONSTRUCTIVE OSTEOTOMY FOR DORSALLY MALUNITED DISTAL RADIUS FRACTURES

Introduction: Common misconceptions about distal radius fractures result in undertreatment, particularly in active population.Loss of reduction can cause a symptomatic malunion. The aim of the study is to present the clinical consequences of a dorsally malunited distal radius fractures and the results of a corrective osteotomy for the treatment of this problem Material: 18 patients with distal radius fractures healed in a dorsal angulation and a mean age of 39 years, treated with a corrective osteotomy. 13 patients had been treated by closed means, and 5 had undergone a earlier surgical procedures without success. 11 patients had a DISI instability of the wrist. 12 patients underwent a radius corrective osteotomy alone, 4 had a cpmined radial osteotomy amd ulnar shortening osteotomy, and 2 underwent only a Sauve-Kapandji procedure. Results: The average follow up was 26 months. All the osteotomies healed. 15 of the deformities were corrected. 7 patients with DISI deformity were regained normal wrists whereas the rest 4 remained with DISI instability. One patient with normal wrist led to DISI instability postop. Conclusion: Distal radius corrective osteotomy is a technically demanding operation, and by no means can guarantee a postop normal anatomy. Furthermore and despite the functional improvement it is unknown the remote consequences wth a ersidual DISI deformity.