Distal Radius Malunion

Distal radius malunion is the result of a previously fractured distal radius poorly healing and being lined up incorrectly. It can cause pain or swelling in the wrist and reduced range of movement.

The osteotomy is required as the malunion affects the joint surface. During the operation, the bone is cute and the fragments are aligned in a better position and are then fixed securely with a plate. The surgeon, in some cases, may also be required to take a bone graft from the hip or use a synthetic bone.

You will find that a dressing and padded bandage with temporary plaster incorporated has been applied to the hand. It is important to keep these dressings clean and dry and begin moving free finger joints after the operation to stop them stiffening. To reduce swelling, keep the arm elevated in the sling provided or resting upon pillows. Pain killers can be taken as when felt necessary.

A new plaster cast will be applied 10-14 days after the surgery usually by the hand therapist after wound check and suture removal. After 10-12 weeks an x-ray will be taken in order to assess the progress of healing. The mobilisation of the wrist may begin at this stage. In the best cases, heavy loading and contact sports may be reintroduced after four to five months and driving may begin when the patient feels confident enough to control a car which may take around two to three months.

Generally, this procedure is considered to be effective. However, some people may have problems. There may be swelling and stiffness of the hand which should decrease with time but if severe and persistent, is called reflex sympathetic dystrophy and is rare. Infection is also rare. There is a risk that the plate or screws may loosen or break and cause further issues or that the bone continues to not heal correctly. Some patients also suffer from long-term stiffness of the wrist joints which can be lessened by hand therapy.