chapter  25
6 Pages

Repair of Distal Radial Malunion with Volar Plating

Osteotomy of a malunited distal radius fracture is indicated for

a healed fracture, which has already produced an unfavorable

outcome, or one that is likely lead to a poor clinical or radio-

graphic result. Historically, osteotomies of the distal radius have

been performed for extra-articular fracture malunions using a

dorsal buttress plate and iliac crest bone grafting (1). Dorsal

plating has been associated with tendon adhesions (2) and iliac

crest bone grafting has donor site morbidity (3). A less invasive

osteotomy technique is now possible that offers improvements

over the established technique. Advances with the new

osteotomy technique are attributable to improved implants,

new surgical techniques, and the recent availability of

synthetic bone graft substitutes. This chapter will focus on use

of a volar surgical approach and volar plate fixation when

performing osteotomy for malunion of the distal radius. Both

extra-and intra-articular malunion will be considered in

this chapter.