Non-union in 3 of 15 osteotomies of the distal radius without bone graft

Figures & data

Figure 1. Left radius, ulnopalmar view. The osteotomy will commonly pivot around the ulnopalmar corner to correct dorsal and radial malangulation as well as malrotation. A. Osteotomy done in line with the previous fracture. B. Triangular defect in 2 planes. C. Trapezoid defect in 2 planes.

Table 1. Cases with postoperative correction, additional factors, and outcome

			Correction
Case	Age	Dorsal angle (°)	Ulnar variance ^a (mm)	Radial height ^a (mm)	Trapezoid void ^b	Smoking	Nonunion
1	41	25	0	2
2	21	27	0	2
3	57	13	1	7		Yes
4	48	15	1	−1
5	27	19	1	2
6	60	31	1	4	Yes	Yes	Yes
7	62	22	0	4		Yes
8	61	14	3	2	Yes
9	56	33	1	−1
10	45	23	0	3	Yes		Yes
11	49	8	−2	0
12	56	40	4	10	Yes
13	53	32	1	4	Yes		Yes
14	59	40	6	7	Yes
15	62	24	1	0

^a Negative values mean shortening of the radius in the PA view.

^b No cortical contact between the fragments.

Figure 2. Non-union in case 13. A. 5 months postoperatively, with sclerosis of the cut surfaces. B. 3 months after revision, with non-structural iliac crest bone graft.