Combined radial closing-wedge osteotomy and ulnar shortening osteotomy for distal radius malunion.

Hand surgery & rehabilitation Pub Date : 2025-06-13 DOI:10.1016/j.hansur.2025.102207

Arnaud Walch, Sabine Pillot, Thais Galissard, Aram Gazarian, Thibault Druel

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Abstract

Purpose: Distal radius malunion alters wrist biomechanics, leading to pain, stiffness, and functional impairment. Various corrective osteotomy techniques exist. The aim of this study was to evaluate the functional outcomes of a combined radial closing-wedge osteotomy and ulnar shortening osteotomy in the treatment of distal radius malunions.

Materials and methods: We retrospectively reviewed 20 patients who underwent combined radial closing-wedge osteotomy and ulnar shortening osteotomy for symptomatic distal radius malunions. Functional outcomes, grip strength, range of motion, and radiographic parameters were analyzed.

Results: Surgery significantly improved supination (20°-80°), flexion (40°-60°), extension (50°-65°), and grip strength (12 kg-22 kg). Ulnar variance correction was achieved. Complications occurred in four cases, with three requiring revision surgery.

Discussion: Combined radial closing-wedge osteotomy and ulnar shortening osteotomy effectively restores wrist function while avoiding graft-related complications. This approach provides an alternative to opening-wedge osteotomies for distal radius malunions.

Level of evidence: IV.

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桡骨远端畸形愈合联合尺侧截骨术。

目的：桡骨远端畸形愈合改变手腕生物力学，导致疼痛、僵硬和功能损害。存在多种矫正截骨技术。本研究的目的是评估桡骨闭合楔形截骨术和尺骨缩短截骨术联合治疗桡骨远端畸形愈合的功能结果。材料和方法：我们回顾性分析了20例桡骨远端畸形连行桡骨闭合楔形截骨联合尺侧截骨术的患者。分析功能结果、握力、活动范围和影像学参数。结果：手术显著改善了旋后（20°至80°）、屈曲（40°至60°）、伸展（50°至65°）和握力（12 kg至22 kg）。完成尺方差校正。4例出现并发症，其中3例需要翻修手术。讨论：桡侧闭合楔形截骨联合尺侧缩短截骨可有效恢复腕关节功能，同时避免移植物相关并发症。该入路为桡骨远端畸形愈合提供了一种开放楔形截骨术的替代方法。证据等级：四级。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Hand surgery & rehabilitation

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