The Journal of Bone and Joint Surgery, Vol 77, Issue 6 894-902, Copyright © 1995 by Journal of Bone and Joint Surgery, Inc
Operative treatment of malunited fractures of the forearm
RT Trousdale and RL Linscheid
Department of Orthopedics, Mayo Clinic, Rochester, Minnesota 55905, USA.
We conducted a retrospective review of the results of twenty-seven
consecutive osteotomies for malunited fractures of the forearm performed at
the Mayo Clinic from 1976 to 1991. There were seventeen male patients and
ten female patients who were an average of nineteen years old (range, nine
to forty-one years old) at the time of the osteotomy. The corrective
osteotomy was performed an average of seventy-three months (range, two to
324 months) after the fracture. The indication for the procedure was
functional loss of motion (average arc of pronation-supination, 74 degrees;
range, 20 to 120 degrees) in twenty patients, an unstable and painful
distal radioulnar joint in six, and an unacceptable appearance of the
forearm in one. Twenty patients had a corrective osteotomy of the radius;
two, of the ulna; and five, of both bones. Of the twenty patients who had a
corrective osteotomy for loss of motion of the forearm, nine were managed
within twelve months after the initial injury and eleven were managed more
than twelve months afterward. The patients who were managed early gained an
average of 79 degrees (range, 20 to 160 degrees) of rotation after the
osteotomy. Those who were managed late gained an average of only 30 degrees
(range, -25 to 95 degrees). A pain-free, stable wrist was achieved in three
of the six patients who were managed for an unstable and painful distal
radio-ulnar joint. However, these six patients lost an average of 7 degrees
(range, -25 to 25 degrees) of rotation of the forearm.(ABSTRACT TRUNCATED
AT 250 WORDS)
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