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

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.