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Review
. 2023 Oct 14;15(10):e47019.
doi: 10.7759/cureus.47019. eCollection 2023 Oct.

Current Concepts: Corrective Osteotomy for Extra-Articular Deformity Following a Distal Radius Fracture

Samuel C Haines  1 , Alasdair Bott  2
Affiliations
Review

Current Concepts: Corrective Osteotomy for Extra-Articular Deformity Following a Distal Radius Fracture

Samuel C Haines et al. Cureus. .

Abstract

Fracture malunion alters wrist and distal radioulnar joint (DRUJ) biomechanics, resulting in incongruence and instability of the DRUJ. Selected patients with painful functional limitation and significant deformity of the radius, but without advanced degenerative joint disease, may benefit from corrective distal radial osteotomy. Non-union and complications arising from metalwork are the most common reasons for reoperation. Surgeons should have a good understanding of risks and complications in order to fully inform their patients and manage expectations. This article reviews the biomechanical effects of radial malunion and the current concepts for treatment. Distal radial osteotomy is suitable for symptomatic patients with angular radial deformity and shortening. Evidence supports a volar approach without bone grafts for modest corrections. Bone grafts or synthetic bone substitutes are appropriate for larger corrections. Functional improvements are reported regardless of technique. Despite a high complication rate, patient satisfaction with the corrective radial osteotomy is high.

Keywords: corrective osteotomy; distal radius fractures; druj injury; extra-articular; wrist fractures.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Established radiographic parameters
Left: Posteroanterior radiograph ulnar variance (UV) = -2mm to +2mm; radial inclination (RI) = 22 degrees; radial height (RH) = 12mm; right: Volar tilt (VT) = 11 degrees; radiolunate angle (RL) = 10 +/- 6 degrees; lunocapitate angle (LC) = 0 +/- 12 degrees
Figure 2
Figure 2. DRUJ schematics
Left: coronal shift fracture; right: normal push-pull relationship of DRUJ DRUJ: distal radioulnar joint
See this image and copyright information in PMC

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