Long-term outcomes of corrective osteotomy for malunited fractures of the distal radius

Abstract

The aim was to investigate the long-term outcome after corrective osteotomy for malunion of distal radius fractures. Radiological findings, function, activity performance, pain, health-related quality of life and self-efficacy were studied. Evaluation of 37 patients 3-10 years after osteotomy fixated with a volar plate. Conventional radiographs were taken. Grip strength and range of motion were evaluated. Scores from the Patient Rated Wrist Evaluation (PRWE) were compared with normative values. The RAND-36 was used for evaluation of health-related quality of life and the General Self-Efficacy scale (S-GSE) for self-efficacy. Radial height, volar tilt, and ulnar variance improved postoperatively. In the long term, the corrections were maintained. Radiographs showed significantly more advanced osteoarthritis. Mean grip strength was 31 kg (SD 13) 89%, and range of motion varied between 80% and 95% compared to the uninjured side. The median PRWE was 12 points (0-99). The study group experienced higher levels of pain than reference values. There was a moderate correlation between the PRWE and volar tilt (rs = 0.453, p = .006) and grip strength (rs = 0.40, p = .014). At long-term follow-up functional outcome after a corrective osteotomy is generally good, but patients may experience some degree of pain. Corrective osteotomy might be considered for patients with a poor functional outcome after a distal radius fracture.

Keywords: Distal radius; corrective osteotomy; long term; malunion; patient-rated outcomes; radiographic outcomes.