Zaid AL-ANI, Khalid SHARIF, Amitabh J DWYER

Sliding rotational osteotomy for cases of dorsally angulated distal radius malunion: A technical note

The aim of this study was to present a novel pre-planned distal radius sliding rotational osteotomy that can address alldeformities in dorsally angulated distal radius malunion through a volar approach using a locking plate. Four consecutiveadult women with symptomatic dorsally angulated distal radius malunion were surgically treated with sliding rotationalosteotomy. All the patients underwent preoperative Disabilities of the Arm, Shoulder and Hand (DASH) scores, a series ofradiography, and a course of physiotherapy. The osteotomy was planned on 2 orthogonal radiographs, and the surgery wasperformed through a volar approach. A back slab was applied post-operatively for two weeks and changed to a removable splintfor further four weeks. Gentle active movements out of splint were permitted at two weeks, and formal physiotherapy at sixweeks post-operatively. Radiographs were taken immediately post-operatively, at three months, and with DASH scores at a meanfinal follow-up of 18 months. On radiographic evaluation, all the deformities were corrected within an acceptable range. Themean increase in radial inclination was 6.5 degrees. The mean gain in radial height was 2.95 mm. The mean improvement inulnar variance was 4.25 mm. The mean change from dorsal to volar angulation was 23 degrees, and the mean improvement in theDASH score was 45.25 at a mean final follow-up of 16 months. All osteotomies achieved bony union within 3 monthspostoperatively. None of the patients required metalwork removal, and no complications were observed. Sliding rotationalosteotomy appears to be a safe technique to correct deformity and improve function in patients with dorsally angulated,shortened, and radially deviated distal radius malunion.

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