Distal radial osteotomy for malunion of wrist fractures in young patients.

Malunion after a fracture of the distal radius in a young patient causes a significant disturbance of wrist function. We have performed distal radial osteotomies in 11 patients to correct radial malunion. Surgery was indicated in young patients with functional disability in the wrist due to limited wrist motion and pain. Many had an unacceptable cosmetic appearance of the wrist. In all patients surgery consisted of opening wedge osteotomies to correct radial tilt and radial angle. In some instances it was not possible completely to restore radial length without a reduction in ulnar length. Post-operatively combined dorsal and volar flexion improved from a mean of 34 degrees to 72 degrees. Combined pronation and supination improved from a mean of 68 degrees to 106 degrees. Pain assessed on a simple four-point functional score was decreased from a mean of 3.3 to 1.3.