ABSTRACT
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.
