Abstract
Background Open wedge osteotomy with bone grafting and plate fixation is the standard procedure
for the correction of malunited distal radius fractures. Bone grafts are used to increase
structural stability and to enhance new bone formation. However, bone grafts are also
associated with donor site morbidity, delayed union at bone–graft interfaces, size
mismatch between graft and osteotomy defect, and additional operation time.
Purpose The goal of this study was to assess bone healing and secondary fracture displacement
in the treatment of malunited distal radius fractures without the use of bone grafting.
Methods Between January 1993 and December 2013, 132 corrective osteotomies and plate fixations
without bone grafting were performed for malunited distal radius fractures. The minimum
follow-up time was 12 months. Primary study outcomes were time to complete bone healing
and secondary fracture displacement. Preoperative and postoperative radiographs during
follow-up were compared with each other, as well as with radiographs of the uninjured
side.
Results All 132 osteotomies healed. In two cases (1.5%), healing took more than 4 months,
but reinterventions were not necessary. No cases of secondary fracture displacement
or hardware failure were observed. Significant improvements in all radiographic parameters
were shown after corrective osteotomy and plate fixation.
Conclusion This study shows that bone grafts are not required for bone healing and prevention
of secondary fracture displacement after corrective osteotomy and plate fixation of
malunited distal radius fractures.
Level of evidence Therapeutic, level IV, case series with no comparison group
Keywords
malunited distal radius fractures - corrective osteotomy and plate fixation - bone
grafts - bone healing - secondary fracture displacement
