Corrective osteotomy for malunion of the distal radius: the effect of concomitant ulnar shortening osteotomy.
Positive ulnar variance due to inadequate correction of radial length is a common disorder after radial corrective osteotomy. To avoid this complication we performed a combination of ulnar-shortening osteotomy and radial corrective osteotomy in 6 of 22 radial corrections. The indication for the combined procedure was a relative ulnar length of minimally 6 mm. The functional outcome was fair in 1 and good in 5 cases with combined osteotomy. Overall, the functional results were good in 17 cases, and pain in the distal radioulnar joint was observed in 3 of 22 patients. Positive ulnar variance was the reason for pain in only 1 patient. Eventually, 2 hemiresections of the ulnar head (Bower's arthroplasty) were performed. It appears that a combination of ulnar shortening and radial osteotomy is a reliable technique, which can reduce symptoms and need for secondary operations on the ulnar side of the wrist.
Oskam
J
J
Department of Surgery, University Hospital Groningen, The Netherlands.
Bongers
K M
KM
Karthaus
A J
AJ
Frima
A J
AJ
Klasen
H J
HJ
D000328:Adult; D005260:Female; D017759:Fractures, Malunited / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010027:Osteotomy / Q000379:methods*; D011859:Radiography; D011884:Radius / Q000000981:diagnostic imaging / Q000601:surgery*; D014457:Ulna / Q000000981:diagnostic imaging / Q000601:surgery*; D014955:Wrist Joint / Q000033:anatomy & histology / Q000000981:diagnostic imaging