Rotational deformity in malunited fractures of the distal radius.
OBJECTIVE
To evaluate rotational deformity in malunited fractures of the distal radius and its effect on forearm rotation.


METHODS
Thirty-seven patients with a symptomatic malunion of the distal radius (25 with dorsal angulation and 12 with volar angulation) were assessed for rotational deformity of the distal fragment. Spiral computed tomographic scans were taken of both wrists. Rotational deformity was evaluated by comparing the radial torsion angle of the injured and uninjured sides according to Frahm. Multivariable regression analyses were used to identify the radiologic parameter that had the most important influence on forearm rotation.


RESULTS
Of the 37 patients, 23 showed a rotational deformity of the distal radius. In both dorsally and volarly angulated malunions, pronation and supination deformities were identified. There was a tendency toward more pronation deformities with volar malunion. Volar angulated malunion with a rotational deformity of less than 10 degrees showed the smallest amount of forearm supination. Losses of pronation-supination did not correlate with the amount of rotational deformity.


CONCLUSIONS
This study showed that rotational deformity is common with angulated malunions of the distal radius. The effect on forearm rotation should not be overestimated. Pretreatment computed tomographic scanning of both wrists to identify and measure malrotation of the distal radius may be helpful to improve the outcome after corrective osteotomy.
Prommersberger
Karl-Josef
KJ
Clinic of Hand Surgery, Rhön-Klinikum, Salzburger Leite 1, D-97615 Bad Neustadt, Germany.
Froehner
Steffen C
SC
Schmitt
Rainer R
RR
Lanz
Ulrich B
UB
D000328:Adult; D000368:Aged; D005260:Female; D005542:Forearm / Q000503:physiopathology*; D017759:Fractures, Malunited / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011403:Pronation / Q000502:physiology; D011446:Prospective Studies; D011859:Radiography; D011885:Radius Fractures / Q000000981:diagnostic imaging / Q000503:physiopathology*; D012044:Regression Analysis; D012399:Rotation; D013484:Supination / Q000502:physiology; D014955:Wrist Joint / Q000000981:diagnostic imaging / Q000503:physiopathology