Surgical Treatment of Malunited Fractures of Radius Distal Metaepiphysis

Sixty three patients with malunited distal radius were treated on from 2008 through 2012. Out of them complex regional pain syndrome was diagnosed in 12 and carpal canal syndrome — in 4 patients. Basing on the examination results the roentgenologic classification of malunited distal radius that enabled to determine the surgical tactics was suggested. Main type of surgical intervention was corrective osteotomy. When radius shortening exceeded 3 mm bone graft from the crest of upper flaring portion of the ilium was used. In patients with complex regional pain syndrome paravasal sympathectomy was performed additionally. In I—II stage of carpal canal syndrome only corrective osteotomy was performed while in II-III stages additional release of hypertrophic transverse carpal ligament and neurolysis in the zone of compression and ischemia were performed. In 12 months after surgery mean score by DASH scale decreased from preoperative 62.2±8.0 to 19.6±7.0 (p<0.0001). Percentage of range of movement restoration in the operated joint varied from 71—75% (flexion-extension) to 93% (pronation-supination) as compared to the health extremity.

corrective osteotomy, bone graft, classification, sympathectomy, complex regional pain syndrome, carpal canal syndrome