Malunited Distal Radius Fractures Corrective Osteotomies Using Volar Locking Plates

Objective: To observe the clinical effect and surgical technique of treating malunited distal radius fractures with corrective osteotomy and volar locking plates.Methods:From August 2016 to August 2018,21 patients with malunions of the distal radius fractures were treated in our department,including 4 males and 17 females.The age ranged from 17 to 78 years,with an average of 55.9 years.All patients were treated with corrective osteotomy and volar locking plate,and allogeneic bone grafting was performed.The patient’s imaging data,wrist mobility,and wrist function were followed up.Results: All the 21 patients were successfully followed up for 6-14 months with an average of 8.7 months.All incisions healed primarily after surgery and no wound infection occurred.X-rays of 20 patients showed fracture union was achieved at the end of follow-up,and 1 case showed bone resorption.At the last follow-up of the patient,the volar tilt angle was(13.8±2.2)°,the ulnar incline angle was(20.3±2.3)°,the ulnar variance was(-1.4±0.9)mm,and the wrist grip strength was(78.7±4.0)% of the healthy side.The Palm activity was 55.2(50.6,57.3)°,the dorsoflexion activity was(59.6±3.1)°,the radial deviation was(15.0±2.4)°,and the ulnar deviation was(24.9±2.4)°.All follow-up indicators were significantly improved compare to preoperative.At the last follow-up,the wrist function score was excellent in 15 cases,good in 3 cases,fair in 3 cases.The excellent and good rate was 85.7%.Conclusions: It is an effective method to treat malunions of the distal radius fractures with corrective osteotomy and volar locking plate.