[Corrective osteotomy for the treatment of carpal tunnel syndrome in malaligned healed fractures of the distal radius].

This report deals with 12 patients with fractures of the distal radius that healed with malpositioning with dorsal sinking of the articular surface. This malalignment was followed in all patients by a compression syndrome of the median nerve. All patients underwent an osteotomy by the dorsal approach to correct this malalignment of the distal radius. The carpal ligament was not released simultaneously. In 11 patients a significant reduction in the typical night pain was noticed. Normal or almost normal sensitivity was achieved within the first 2 months (2 weeks to 4 months). Only in one patient was release of the carpal ligament necessary after 6 months, because the osteotomy had no effect on the pain. In the follow-up examination after 6 years, significantly better wrist function was noticed in all patients, and 11 had normal function of the median nerve. In only one patient with moderate loss of sensitivity still present, although these was an obvious significant reduction in pain. In this patient the osteotomy was performed very late (after 10 months). Thus, an osteotomy by the dorsal approach has the advantage of restoring normal function of both the wrist and median nerve.