[Corrective interventions in malunited fractures of the distal radius].

Abstract

The current indications and technique of wrist osteotomies for ununited fractures of the distal radius are presented. A three-dimensional correction at the metaphyseal level is technically feasible. This not only restores the normal orientation of the articular surface thus reestablishing normal load distribution but also the radial length up to 10 mm which is a prerequisite to prevent ulno-carpal impingement. Painful limitation of forearm rotation due to degenerative changes in the distal radioulnar joint may be treated with Bowers hemiresection arthroplasty. If the radioulnar index should be greater than 10-12 mm an additional shortening osteotomy of the ulna may become necessary. Every additional operation on the ulna should be based on the radiological comparison of the distal radioulnar joint of the opposite hand.