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J Am Acad Orthop Surg, Vol 15, No 1, January 2007, 27-40.
© 2007 the American Academy of Orthopaedic Surgeons
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Malunion of the Distal Radius

Brandon D. Bushnell, MD and Donald K. Bynum, MD

Dr. Bushnell is Resident, Department of Orthopaedic Surgery, University of North Carolina Hospitals, Chapel Hill, NC. Dr. Bynum is Professor, Department of Orthopaedic Surgery, University of North Carolina Hospitals.

None of the following authors or the departments with which they are affiliated has received anything of value from or owns stock in a commercial company or institution related directly or indirectly to the subject of this article: Dr. Bushnell and Dr. Bynum.

Reprint requests: Dr. Bushnell, Department of Orthopaedic Surgery, University of North Carolina Hospitals, 101 Manning Drive, CB 7055, Chapel Hill, NC 27713.

Fractures of the distal radius are common injuries. Acceptable results typically can be obtained with appropriate surgical or nonsurgical management. However, a small percentage of these fractures can progress to symptomatic malunion, which traditionally has been treated with osteotomy of the distal radius. Proper understanding of anatomy, biomechanics, indications, and contraindications can help guide patient selection for surgery. In formulating a treatment plan, the surgeon also must consider such technical variables as the type of osteotomy, the use of bone graft or bone-graft substitute, and the means of fixation to stabilize the osteotomy. Simultaneous implementation of an ulnar-side procedure, an intra-articular osteotomy, and soft-tissue releases also may be necessary. Some cases may be more appropriate for wrist fusion or other salvage procedures.






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Copyright © 2007 by the American Academy of Orthopaedic Surgeons.