title: OSTEOTOMY OF THE DISTAL RADIUS USING A FIXED-ANGLE VOLAR PLATE.
abstract: OBJECTIVE
  Skewed consolidation of the distal radius, due to sequelae of fractures, may cause functional incapacity, thus leading such patients to present pain, loss of strength and diminished mobility. Based on the excellent results obtained from surgical treatment of unstable fractures of the distal radius through a volar approach and use of rigid fixation with a fixed-angle volar plate, we started to use the same method for osteotomy of the distal radius.
  
  
  METHODS
  A retrospective review was conducted, and 20 patients treated between February 2002 and October 2009 were found. The mean length of follow-up was 43.9 months (range: 12 to 96 months). The surgical indications were persistent pain, deformity and functional limitation subsequent to a dorsally displaced fracture.
  
  
  RESULTS
  The mean preoperative deformity was 27° of dorsal tilt of the distal radius, 87° of ulnar tilt, and 7.3 mm of shortening of the radius. All the osteotomies consolidated and the final mean volar tilt was 6.2°, with ulnar tilt of 69.3° and shortening of 1 mm. The mean mobility of the wrist increased by 19.9° (flexion) and by 24° (extension). Mean forearm supination increased by 23.5° and pronation by 21.7°. Grip strength increased from 13.4 to 34.5 pounds.
  
  
  CONCLUSIONS
  Use of a fixed-angle volar plate for a volar approach towards osteotomy of the distal radius enables satisfactory correction of the deformities and eliminates the need for removal of the synthesis material caused by tendon complications.
authors.affiliation: Orthopedist in the Hand Group, Santa Casa de Porto Alegre, Porto Alegre, RS, Brazil.
authors.forename: Ricardo Kaempf
authors.initials: RK
authors.lastname: de Oliveira
authors.affiliation: Resident Physician in Orthopedics, Santa Casa de Porto Alegre, Porto Alegre, RS, Brazil.
authors.forename: Mário Arthur Rockenbach
authors.initials: MA
authors.lastname: Binz
authors.affiliation: Resident Physician in Orthopedics, Santa Casa de Porto Alegre, Porto Alegre, RS, Brazil.
authors.forename: Marco Tonding
authors.initials: MT
authors.lastname: Ferreira
authors.affiliation: Orthopedist and Head of the Hand Group, Santa Casa de Porto Alegre, Porto Alegre, RS, Brazil.
authors.forename: Paulo Henrique
authors.initials: PH
authors.lastname: Ruschel
authors.affiliation: Orthopedist at Hospital Fremap, Madrid, Spain.
authors.forename: Pedro Delgado
authors.initials: PD
authors.lastname: Serrano
authors.affiliation: Orthopedist in the Hand Group, Santa Casa de Porto Alegre, Porto Alegre, RS, Brazil.
authors.forename: Rafael Pêgas
authors.initials: RP
authors.lastname: Praetzel
keywords: Colles' Fracture/complications; Fracture Fixation, Internal; Osteotomy/utilization