Purpose
To quantify 2 patterns of carpal malalignment, midcarpal malalignment (type 1) and
radiocarpal malalignment (type 2), and to evaluate the effect of distal radius osteotomy
on these malalignment patterns.
Methods
In a retrospective review, we studied 31 wrists treated with corrective osteotomy
for distal radius malunion after Colles' fracture, in 31 patients (mean age, 44 y).
The patients were divided on the basis of effective radiolunate flexion (ERLF) into
2 patterns of carpal malalignment as measured on preoperative radiographs. There were
20 patients with midcarpal malalignment (ERLF ≤ 25°) and 11 with radiocarpal malalignment
(ERLF > 25°). Measurements of alignment were repeated after distal radius osteotomy
and compared with preoperative values.
Results
Both groups had correction of radial tilt and ulnar variance with distal radius osteotomy.
In the midcarpal malalignment group, carpal alignment improved to normal parameters.
In the radiocarpal malalignment group, we observed a notable effect on the ERLF. Neither
age of the subject nor delay between fracture and osteotomy correlated with improvement
in carpal alignment.
Conclusions
Distal radial osteotomy is a reliable technique for correction of the deformity at
the distal end of the radius and both radiocarpal and midcarpal malalignment.
Type of study/level of evidence
Therapeutic IV.
Key words
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Article info
Publication history
Accepted:
September 25,
2009
Received:
May 15,
2009
Footnotes
No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.
Identification
Copyright
© 2010 Published by Elsevier Inc.
