title: Correction of nascent malunion of distal radius fractures.
abstract: OBJECTIVE
  Early correction of malunion of distal radius fractures may be necessary in young, active patients. The aim of this study was to report the advantages and disadvantages of early correction of distal radius malunion.
  
  
  METHODS
  Eleven patients (10 male, 1 female; average age 36 years, range: 20 to 54 years) with nascent malunion of distal radius fractures were included in this study. The malunions occurred after initial conservative treatment of unstable distal radius fractures. Mean interval between injury and corrective surgery was 12 (range: 8 to 15) weeks. Two patients had intra- and extra-articular malunion and 9 had an extra-articular malunion. Volar correction was made in seven patients and dorsal correction in four. Results were evaluated radiologically and functionally using the Mayo wrist score.
  
  
  RESULTS
  Bony healing was established after correctional osteotomies at an average of 8 (range: 5 to 16) weeks. The average preoperative dorsal deformity was 28° and was corrected to 4° of volar tilt postoperatively. Patients had a positive ulnar variance with an average of 5 mm initially and less than 1 mm postoperatively. Radial inclination was corrected from an average of 9° preoperatively to an average of 20° and the average postoperative Mayo wrist score was 82.5. Tenotomy of brachioradialis was useful for the correction of radial inclination, especially in old cases. Structural (corticocancellous) grafting was used in one patient. All patients returned to their previous functional level.
  
  
  CONCLUSIONS
  Advantages of early corrective osteotomy include anatomic restoration at the original fracture line, a shortened healing period and a decreased need for structural bone grafting. Disadvantages are that the recreation of the original fracture line is technically demanding and patients must be cooperative to achieve a successful outcome.
authors.affiliation: Department of Orthopedics and Traumatology, Division of Hand Surgery, Faculty of Medicine, Ankara University, Turkey.
authors.forename: S Sinan
authors.initials: SS
authors.lastname: Bilgin
authors.forename: Mehmet
authors.initials: M
authors.lastname: Armangil
mesh_terms: D000328:Adult; D003100:Colles' Fracture / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000009:adverse effects* / Q000379:methods; D017759:Fractures, Malunited / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D010027:Osteotomy / Q000295:instrumentation / Q000379:methods*; D053401:Palmar Plate / Q000601:surgery*; D011859:Radiography; D016059:Range of Motion, Articular; D020127:Recovery of Function; D012189:Retrospective Studies; D058971:Tenotomy / Q000379:methods; D013997:Time Factors; D016896:Treatment Outcome; D014954:Wrist Injuries / Q000000981:diagnostic imaging / Q000601:surgery