Distal Radius Malunions

This chapter presents a clinical scenario of a 59-year-old healthy woman who had injures in her dominant wrist after a fall at home. Her wrist radiographs show a displaced extra-articular distal radius fracture with a dorsal angulation of 15 ° (from 0 °) and an ulnar variance of 3 mm. The treating surgeon has a discussion with the patient about surgical and nonsurgical treatment options and the expected outcomes in case the fracture heals with malunion or in a near anatomical position. They also discuss which treatment method would be most effective in restoring near normal anatomy. Treatment of displaced distal radius fractures has shifted toward increasing use of open reduction and fixation with volar locking-plate. Distal radius osteotomy (sometimes combined with ulnar osteotomy) is a major surgical procedure that requires substantial postoperative rehabilitation.