Corrective Osteotomy With K-Wire Fixation For the Treatment of Symptomatic Distal Radius Extra-Articular Malunion

Abstract

Background: Optimization of the corrective osteotomy for the treatment of distal radius extra-articular ‎ ‎malunion is an ‎ongoing project‎‏. Objectives: In this study, ‏we aimed to evaluate the outcome of corrective osteotomy ‎with K-wire fixation in the treatment of patients with symptomatic distal radius extra-articular malunion.‎ Patients & Methods: Twenty-three patients with symptomatic distal radius extra-articular malunion, mean ‎age of ‎38.3±7.6‎‏ years‎, ‎and a mean follow‎-‎up of ‏‎34.4±11.3 months‎‏ were included‎. ‎Corrective osteotomy ‏was performed through a dorsal approach and using K‎-‎wire instead of the plate for the fixation ‏of the osteotomy site‎. ‎The outcome was assessed with radiographic measures including ‏ulnar ‎variance, radial tilt, radial inclination angle, radial height, and clinical measures including ‎wrist range of motion, the short form of Disabilities of the Arm, Shoulder, and ‎Hand (Quick-‎DASH), and the Modified Mayo Wrist Score (MMWS).‎ Results: Radiographic measures and wrist range of motion in all directions were significantly improved at the last follow-up. The mean final Quick-DASH score of the patients was 16.3±8. The mean final MMWS was 92.2±13.5. According to the MMWS, 9 (39.1%) patients had an excellent function, 13 (56.5%) patients had a good function, and one (4.4%) patient had a fair function. Radiographic union was observed in all wrists within an average period of 10.2±4 weeks. No postoperative complication was recorded. Conclusion: Since K-wire fixation is less expensive, requires smaller incision, and provides acceptable radiologic and clinical outcomes, it could be regarded as a good alternative for plate fixation in corrective osteotomy for distal radius extra-articular malunion.