Malunion of the distal radius

Abstract

Fractures of the distal radius are extremely common injuries, which are steadily becoming a public health issue. One of the most common complications following distal radius fractures is still malunion of the distal radius. This review of the literature surrounding distal radius malunion covers the biomechanics of distal radial malunion, treatment options, indications for surgery, surgical techniques, and results.

Management of Complications of Distal Radius Fractures

“…A malunited distal radius fracture can be extra-articular, intra-articular or both [29] and occurs when a fracture heals with improper alignment, articular incongruity, incorrect length, or a combination of these elements [30]. Extra-articular malunions are commonly characterized by a loss of the normal palmar tilt of the articular surface in the sagittal plane, a loss of ulnar inclination in the frontal plane, and a loss of length relative to the ulna [29]. Conversely, an intra-articular malunion is frequently associated with a step-off or a gap at the radiocarpal joint and/or the distal radioulnar joint [29].…”

“…Extra-articular malunions are commonly characterized by a loss of the normal palmar tilt of the articular surface in the sagittal plane, a loss of ulnar inclination in the frontal plane, and a loss of length relative to the ulna [29]. Conversely, an intra-articular malunion is frequently associated with a step-off or a gap at the radiocarpal joint and/or the distal radioulnar joint [29]. …”

“…Malunited distal radius fractures are associated with a variety of symptoms including decreased grip strength, decreased wrist mobility, increased pain, and worsened cosmetic appearance [29, 32]. Patients may also present with pain over the ulnar wrist, caused by either a distal radio-ulnar joint (DRUJ) incongruity or an ulna impaction [30].…”

Three-dimensional virtual planning of corrective osteotomies of distal radius malunions: a systematic review and meta-analysis

“…Within these limits, symptoms of distal radius malunions are expected to be minimal [8]. Nonetheless, acceptable values vary between individuals.…”

Die fehlverheilte distale Radiusfraktur – Langzeit­ergebnisse nach extraartikulärer Korrekturosteotomie

“…▼ Zur Behandlung symptomatischer, in Fehlstellung ausgeheilter extra-und intraartikulärer Radiusfrakturen hat sich die Umstellungsoperation des distalen Radius bewährt, wie die kurz-und mittelfristigen Ergebnisse aus mehr als 200 Publikationen seit 1932 zum Thema belegen [ 1 ] . Umso erstaunlicher ist es, dass nur in 2 Veröff entlichungen über Langzeitergebnisse berichtet wird, beweist doch erst ein positiver Langzeitverlauf den absoluten Wert einer Behandlungsmethode.…”