To study the outcome of distal radius malunion correction with preservation of distal radioulnar joint (DRUJ).

Methods

We believe that an intact DRUJ is important in the function of the hand. Most previous techniques used to correct distal radius malunions disrupt the functional integrity of the DRUJ. We adopted a surgical technique which preserved the DRUJ, in correction of distal radius malunions. Our technique includes radius osteotomy and bicorticocancellous bone graft with ulnar diaphyseal shortening .

Medical records of 21 patient’s were reviewed to compare the pre & post operative functional parameters in patients whose DRUJ was preserved. We compared – grip strength, forearm pronation/supination, wrist flexion/extension, patient reported improvement in pain and symptoms x-ray , and work status.

Results

Of the 21 patients, two were restricted to one handed duty, and 19 (90%) at their final visit were released without restrictions.

The increase in grip strength ranged from -5 to 75 pounds, average increase of 33 pounds. The range of increase was -20 to 320% with an average increase was 150% of the preop value. One patient had reduced grip strength post op.

Pronation improvement ranged from 5 to 60 degrees, average improvement of 33 degrees. Compared to the pre op values the range of improvement was 5 to 200% with an average improvement of 83%

Supination improvement ranged from -15 to 70 degrees, average improvement of 28 degrees. Compared to the pre operative values the range of improvement was -42 to 200% with an average improvement of 79%. One patient had decreased supination post op.

Flexion improvement ranged from -20 to 65 degrees, average improvement of 20 degrees. Compared to pre operative values the range of improvement was -30 to 180% with an average improvement of 46%. Two patients had reduced flexion post op.

Extension improvement ranged from -10 to 55 degrees,average improvement of 19 degrees. Compared to pre operative values the range of improvement was -40 to 300% with an average of 70%. Two patients had reduced extension post op

Conclusion

Preservation of functional integrity of DRUJ is important in functional restoration following correction of malunion of distal radius.

We are comparing these results with a similar cohort of patients who were treated with Darrach’s procedure