Corrective Osteotomy for Malunited, Palmarly Displaced Fractures of the Distal Radius

Background: In spite of the considerable information regarding the indications for, and the techniques and results of, corrective osteotomy of malunited, dorsally displaced fractures of the distal radius, there have been few reports concerning osteotomy of palmarly angulated malunions of the distal radius. The purpose of the current study was to evaluate our experience with this condition. Patients and Methods: We retrospectively reviewed 20 patients, which were operated on for a malunited, palmarly tilted fracture of the distal radius between 1993 and 1998. The investigated criteria included range of motion, grip strength, pain relief, and X-ray findings. Wilcoxon's sign-rank test was used to evaluate the extent of improvement concerning these criteria. Results: At an average of 18 months after osteotomy, radiographs revealed a statistically highly significant improvement in all radiologic parameters. The increase in ulnar and radial deviation of the wrist, and forearm supination, as well as the decrease of pain were statistically highly siginificant. The resultant improvement in grip strength in the current series was significant. Conclusion: Corrective osteotomy of palmarly displaced malunions of the distal end of the radius just as in the case of their dorsal counterparts is of great benefit and leads to improved hand and wrist function as well as diminished pain.