Skip to main content

Malunion of the Distal End of the Radius

  • Chapter
Fractures of the Distal Radius

Abstract

Union with deformity continues to be the most common complication following fracture of the distal end of the radius.7,31,32 Malunion may be extraarticular, characterized by metaphyseal angulation and loss of radial length; intraarticular, involving distortion of the either the radiocarpal or the radioulnar joints or both; or a combination of the two.

Fractures of the radius within two inches of the wrist, where treated by the most eminent surgeons, are of very difficult management so as to avoid all deformity; indeed, more or less deformity may occur under the treatment of the most eminent surgeons, and more or less imperfection in the motion of the wrist or radius is very apt to follow for a longer or shorter time. Even when the fracture is well cured, an anterior prominence at the wrist, or near it, will sometimes result from the swelling of the soft parts.

As the above opinion of Professor Mott coincides with my own observations, both in Europe and in this city, as well as with many of our most distinguished surgical authorities, I venture to hope that it may assist in removing some of the groundless and ill-merited aspersions which are occasionally thrown on the members of our profession by the ignorant or designing. Boston Med. Surg. J. XXV, p. 289

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 74.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Baciu C: L’opération de Sauvé-Kapandji du traitement des cals vicieux de l’extrémité inférieure du radius. Ann Chir 31: 323–330, 1976.

    Google Scholar 

  2. Bowers WH: Distal radioulnar joint arthroplasty: The hemi-resection interposition technique. J Hand Surg 10A: 169–178, 1985.

    Google Scholar 

  3. Boyd HB, Stone MM: Resection of the distal end of the ulnar. J Bone Joint Surg 26: 313–321, 1944.

    Google Scholar 

  4. Bunnell S (ed): Surgery of the Hand. 2nd edition. Philadelphia: JB Lippincott 596: 681–682, 1948.

    Google Scholar 

  5. Campbell WC: Malunited Colles’ fractures. JAMA 109: 1105–1108, 1937.

    Article  Google Scholar 

  6. Castaing J: Les fractures récentes de l’extremité inférieure du radius chez l’adulte. Rev Chir Orthop, 50: 581–696, 1964.

    PubMed  CAS  Google Scholar 

  7. Cooney WP III, Dobyns JH, Linscheid RL: Complications of Colles’ fractures. J Bone Joint Surg [Am] 62A: 613–619, 1980.

    Google Scholar 

  8. Darrach W: Partial excision of the lower shaft of the ulnar for deformity following Colles’ fracture. Ann Surg 57: 764–765, 1913.

    Google Scholar 

  9. Desault M: Extrait d’un mémoire de M. Desault sur la luxation de l’extremité inférieure du cubitus. J Chir 1: 78, 1791.

    Google Scholar 

  10. Durman DC: An operation for correction of deformities of the wrist following fracture. J Bone Joint Surg 17: 1014–1016, 1935.

    Google Scholar 

  11. Durman DC: Malunited Colles’ fracture, abstract: Discussion of Dr. Campbell’s article. JAMA 109: 1105–1108, 1937.

    Article  Google Scholar 

  12. Fernandez DL: Radial osteotomy and Bowers arthroplasty for malunited fractures of the distal end of the radius. J Bone Joint Surg 70A: 1538–1551, 1988.

    Google Scholar 

  13. Fernandez DL: Correction of posttraumatic wrist deformity in adults by osteotomy, bone grafting, and internal fixation. J Bone Joint Surg 4A: 1164–1178, 1982.

    Google Scholar 

  14. Fernandez DL: Correction of posttraumatic wrist deformity in adults by osteotomy, bone grafting, and internal fixation. J Bone Joint Surg 64A: 1164–1178, 1982.

    Google Scholar 

  15. Fernandez DL: Osteotomias del antebrazo distal. Indication, técnica y resultados. Acta Orthop Latinoamerica 11: 55–72, 1984.

    Google Scholar 

  16. Fernandez DL, Albrecht HU, Saxer U: Die Korrekturosteotomie am distalen Radius bei posttraumatischer Fehlstellung. Arch Orthop Unfallchir 90: 199–211, 1977.

    Article  PubMed  CAS  Google Scholar 

  17. Fernandez DL, Geissler WB: Korrektureingriffe bei Fehlstellung am distalen Radius. Z Unfallchir Med Berufskr 82: 34–44, 1989.

    CAS  Google Scholar 

  18. Forgon M, Mammel E: Unsere Korrekturosteotomie in Fehlstellung geheilter Frakturen der Speiche an der typischen Stelle. Unfall Chir 9: 318–324, 1983.

    CAS  Google Scholar 

  19. Fourrier P, Bardy A, Roche G, Cisterne JP, Chambon A: Approche d’une définition du cal vicieux du poignet. Int Orthop (SICOT) 4: 299–305, 1981.

    CAS  Google Scholar 

  20. Ghormley RK, Mroz RJ: Fractures of the wrist: A review of one hundred and seventy six cases. Surg Gynecol Obstet 55: 377–381, 1932.

    Google Scholar 

  21. Hobart MH, Kraft GL: Malunited Colles’ fracture. Am J Surg 53: 55–60, 1941.

    Article  Google Scholar 

  22. Jupiter JB, Ruder J, Roth DA: Computer-generated bone models in the planning of osteotomy of multidirectional distal radius malunions. J Hand Surg 17A: 406–415, 1992.

    Google Scholar 

  23. Kaukone JP, Karaharju EO, Porras M: Functional recovery after fractures of the distal forearm: Analysis of radiographic and other factors affecting the outcome. Ann Chir Gyn 77: 27–31, 1988.

    Google Scholar 

  24. Kazuki K, Masakata K, Shimazu A: Pressure distribution in the radiocarpal joint measured with a densitometer designed for pressure sensitive film. J Hand Surg 16A: 401–408, 1991.

    Google Scholar 

  25. King GJ, McMurtry RY, Rubenstein JD, et al: Computerized tomography of the distal radioulnar joint. A correlation with ligamentous pathology in a cadaveric model. J Hand Surg 11A: 711–717, 1986.

    Google Scholar 

  26. Knirk JL, Jupiter JB: Intraarticular fractures of the distal end of the radius in young adults. J Bone Joint Surg [Am] 68A: 647–659, 1986.

    Google Scholar 

  27. Lichtman DM, Schneider JR, Swafford AR, et al: Ulnar midcarpal instability: Clinical and laboratory analysis. J Hand Surg 6: 515–523, 1981.

    CAS  Google Scholar 

  28. Linscheid RL, Dobyns JH, Beabout JW, et al: Traumatic instability of the wrist. Diagnosis, classification, and pathomechanics. J Bone Joint Surg [Am] 54A: 1612–1632, 1972.

    Google Scholar 

  29. Marsh JL, Vannier MW: Surface imaging from computerized tomographic scans. Surgery 94: 159–165, 1983.

    PubMed  CAS  Google Scholar 

  30. Martini AK: Die sekundäre Arthrose des Handgelenkes bei der in Fehlstellung verheilten und nicht korrigierten distalen Radiusfrakturen. Aktuel Traumatol 16: 143–148, 1986.

    PubMed  CAS  Google Scholar 

  31. McQueen M, Caspers J: Colles’ fracture: Does the anatomic result affect the final function? J Bone Joint Surg [Br] 70B: 649–651, 1988.

    Google Scholar 

  32. Meine J: Die Früh- und Spätkomplikationen der Radiusfraktur loco classico. Z Unfallchir Vers Med Berufsk 82: 25–32, 1989.

    CAS  Google Scholar 

  33. Merle d’Aubigné R, Joussement L: A propos du traitement des cals vicieux de l’extrémité inférieure du radius. Mem Acad Chir 71: 153–157, 1945.

    Google Scholar 

  34. Merle d’Aubigné R, Tubiana R: Séquelles de traumatismes du poignet. In: Traumatismes Anciens. Généralités Membre Supérieur. Paris: Masson, 1958, pp. 361–376.

    Google Scholar 

  35. Milch H: Cuff resection of the ulnar for malunited Colles’ fracture. J Bone Joint Surg 23: 311–313, 1941.

    Google Scholar 

  36. Moore EM: Three cases illustrating luxation of the ulnar in connection with Colles’ fracture. Med Rec NY 17: 305–308, 1880.

    Google Scholar 

  37. Mino DE, Palmer AK, Levinsohn M: The role of radiography and computerized tomography in the diagnosis of subluxation and dislocation of the distal radioulnar joint. J Hand Surg 8A: 23–31, 1983.

    Google Scholar 

  38. Palmer AK, Werner FW: Biomechanics of the distal radioulnar joint. Clin Orthop 187: 26–35, 1984.

    PubMed  Google Scholar 

  39. Palmer AK, Glisson RR, Werner FW: Ulnar variance determination. J Hand Surg 7: 376–379, 1982.

    CAS  Google Scholar 

  40. Poque DJ, Viegas SF, Patterson RM, et al: Effects of distal radius fracture on wrist joint mechanics. J Hand Surg 15A: 721–727, 1990.

    Google Scholar 

  41. Posner MA, Ambrose L: Malunited Colles’ fracture. Correction with a biplanar closing wedge osteotomy. J Hand Surg 16A: 1017–1026, 1991.

    Google Scholar 

  42. Rodriguez-Megthiaz AM, Chamay A: Traitement des cals vicieux extra-articulaires du radius distal par ostéotomie d’ouverture avec interposition d’une greffe. Med Hyg 46: 2757–2765, 1988.

    Google Scholar 

  43. Sakai K, Doi K, Ihara K, et al: Carpal alignment after fractures of the distal radius, abstract. Presented at the International Symposium on the Wrist, Nagoya, Japan, 1991. p. 117.

    Google Scholar 

  44. Shaw JA, Bruno A, Paul EM: Ulnar styloid fixation in the treatment of post-traumatic instability of the radioulnar joint. A biomechanical study with clinical correlation. J Hand Surg 15A: 712–720, 1990.

    Google Scholar 

  45. Short WH, Palmer AK, Werner FW, et al: A biomechanical study of distal radius fractures. J Hand Surg 12A: 529–534, 1987.

    Google Scholar 

  46. Speed JS, Knight RA: Treatment of malunited Colles’ fractures. J Bone Joint Surg 27: 361–367, 1945.

    Google Scholar 

  47. Sauvé L, Kapandji M: Une nouvelle technique de traitement chirurgical des luxations recidivantes isolées de l’extremité cubitale inférieure. J Chir 47: 589–594, 1936.

    Google Scholar 

  48. Taleisnik J, Watson HK: Midcarpal instability caused by malunited fractures of the distal radius. J Hand Surg 9A: 350–357, 1984.

    Google Scholar 

  49. Vannier MW, Totty WG, Stevens WG, et al: Musculoskeletal application of three-dimensional surface reconstructions. Orthop Clin North Am 16: 543–555, 1985.

    PubMed  CAS  Google Scholar 

  50. Villar RN, Marsh D, Rushton N: Three years after Colles’ fracture. A prospective review. J Bone Joint Surg [Am] 69B: 635–638, 1987.

    Google Scholar 

  51. Watson HK, Ryu J, Burgess RC: Matched distal ulnar resection. J Hand Surg 11A: 812–817, 1986.

    Google Scholar 

  52. Weeks PM, Vannier MW, Stevens WG, et al: Three-dimensional imaging of the wrist. J Hand Surg 10A: 32–39, 1985.

    Google Scholar 

  53. Zancolli EA: personal communication.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

Copyright information

© 1996 Springer-Verlag New York, Inc.

About this chapter

Cite this chapter

Fernandez, D.L., Jupiter, J.B. (1996). Malunion of the Distal End of the Radius. In: Fractures of the Distal Radius. Springer, New York, NY. https://doi.org/10.1007/978-1-4684-0478-4_10

Download citation

  • DOI: https://doi.org/10.1007/978-1-4684-0478-4_10

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4684-0480-7

  • Online ISBN: 978-1-4684-0478-4

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics