[Mal-united fractures of the distal radius--biomechanics and operative treatment options].

Despite all progress in the treatment of distal radius fractures, malunion is still one of the most common complications. It may be true that not all non-anatomically aligned fractures of the distal radius are causing disabilities. However, most patients with a distal radial malunion complain about loss of wrist motion and forearm rotation, loss of grip strength, and pain. These complaints should lead to a sophisticated clinical examination and a careful evaluation of the radiographs of the wrist, and - if needed - to further investigations. Treatment options are procedures solely aimed to diminish pain, procedures aimed to improve wrist and forearm function without restoration of the anatomic relationships, and procedures aimed to restore the anatomy of the wrist joint, especially corrective osteotomy of the radius. Radial corrective osteotomy improves significantly wrist and forearm function, grip strength, and diminishes pain. The clinical results are as good or better than the radiological results.