J Korean Orthop Assoc.  2001 Jun;36(3):191-198.

One-stage Corrective Osteotomy for Malunion of Distal Radius Fracture using an Iliac Bone Graft

Affiliations
  • 1Department of Orthopedic Surgery, Seoul National University College of Medicine, Seoul, Korea.

Abstract

PURPOSE
One-stage corrective osteotomy of a symptomatic malunion of a distal radius fracture, is not easy because of the contracture of surrounding soft tissues. We have treated these malunions by a one-stage corrective osteotomy procedure that uses an intraoperative gradual distraction method of the osteotomy site. We have analysed the clinical and radiological results of our procedure, retrospectively.
MATERIALS AND METHODS
We have operated on 7 wrists of 7 patients who had malunion of a distal radius fracture who complained of both wrist pain and functional impairment. The distal radius was osteotomized and distracted gradually for 20 to 30 minutes using a lamina spreader. Then the gap was filled with a pre-designed iliac bone graft. The results were analysed functionally using the Cooney's wrist score, cosmetically using Ladd's method, and radiologically using Kreder's method.
RESULTS
The Cooney's wrist score improved from an average 44 preoperatively to 91 at the latest follow-up. The clinical results were excellent in 4 patients, good in 2 patients and fair in one patient.
CONCLUSION
A one-stage corrective osteotomy with iliac bone graft using a laminar spreader is followed by creep phenomenon is an useful method for the treatment of the malunion of distal radius fracture.

Keyword

distal radius; malunion; one-stage corrective osteotomy; iliac bone graft
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