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The Journal of Bone and Joint Surgery (American) 83:1244-1265 (2001)
© 2001 The Journal of Bone and Joint Surgery, Inc.

Selected Instructional Course Lecture

Complications Following Distal Radial Fractures

Jesse B. Jupiter, MD and Diego L. Fernandez, MD

An Instructional Course Lecture, American Academy of Orthopaedic Surgeons
Jesse B. Jupiter, MD
Orthopaedic Hand Service, Massachusetts General Hospital, ACC 527, 15 Parkman Street, Boston, MA 02114. E-mail address: jjupiter1@partners.org
Diego L. Fernandez, MD
Department of Orthopaedic Surgery, University of Bern, Lindenhof Hospital, Bremgartenstrasse 119, Bern CH 3012, Switzerland. E-mail address: diegof@bluewin.com

The authors did not receive grants or outside funding in support of their research or preparation of this manuscript. They did not receive payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.

Printed with permission of the American Academy of Orthopaedic Surgeons. This article, as well as other lectures presented at the Academy’s Annual Meeting, will be available in March 2002 in Instructional Course Lectures, Volume 51. The complete volume can be ordered online at www.aaos.org, or by calling 800-626-6726 (8 a.m.-5 p.m., Central time).

Malunion of the Distal End of the Radius

Union with deformity is the most common complication following a distal radial fracture1-5. The deformity may be extra-articular, characterized by loss of length and metaphyseal angulation; it may be intra-articular, involving either the radiocarpal or the radioulnar joint, or both; or it may be a combination of the two.

Surgical treatment of a symptomatic malunion of the distal part of the radius has been recognized for more than 200 years. Resection of the distal aspect of the ulna for the management of pain at the distal radioulnar joint after a distal radial fracture, a procedure attributed to Darrach after his description in 19136, had been suggested by Desault in 17917 and again by Moore in 18808. In 1937, Campbell described a corrective osteotomy of the distal part of the radius with use of an interpositional bone graft obtained from the distal part of the ulna9. In . . . [Full Text of this Article]


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