Ulnar Shortening and Radius Corrective Osteotomy in Distal Radius Malunion: A Case Report

Tian Mao^*, Shuguo Xing, Guheng Wang

Department of Hand Surgery, Affiliated Hospital of Nantong University, Nantong 226001, Jiangsu, China

Background: The aim of this study was to present a case with severe malunion of the intra-articular right distal radius without formal treatment after injury.

Case presentation: A 73-year-old male was admitted to our hospital with a severely malunited right distal radius intra-articular fracture 3 months after an injury without treatment. He presented to a regional hospital, where he was suggested to undergo an open reduction and internal fixation for the distal radius fracture 3 weeks after a fall down injury. After declining treatment, the patient developed volar metaphyseal angulation, which led to severe wrist joint pain and restricted movement. After discussing options with his surgeons, corrective surgical treatment was planned. Because of the malunion, the ulnar shortening and radius corrective osteotomy with both volar and dorsal approaches plating were done. A follow-up evaluation 10 months after surgery showed a deformity correction of the radial volar inclination and height, and restitution of the distal radioulnar joint. 

Conclusion: This case report offers an overview on an uncommon case of distal radius malunion treated successfully with a corrective osteotomy using dorsal and volar approaches. Corrective surgery was the primary therapy of choice in this case.