Guoyun Bu*, Wanfu Wei*, Jian’an Li, Tao Yang, Mingxin Li

Department of Orthopedic, Tianjin Hospital, Tianjin, China

Keywords: Distal radius fracture; locking plate; malunion; open fracture; osteotomy.


Objectives: This study aims to investigate the effectiveness of open reduction through original fracture line and fixation with locking plate in treatment of extra-articular distal radius fracture (DRF) malunion.

Patients and methods: Between January 2015 and December 2018, a total of 69 patients (27 males, 42 females; mean age: 62.0±8.9 years; range, 46 to 70 years) suffering from symptomatic extra-articular DRF malunion were included. All patients were followed for more than six months. Patient’s demographics, hand dominance, data including Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) questionnaire, pain on a Visual Analog Scale (VAS) score, radius height, ulnar variance, wrist range of motion, volar tilt and radial inclination before and after surgery were analyzed.

Results: The median follow-up was 14.13 months, and the median time to fracture healing after the operation was 14.25 weeks. The mean QuickDASH score and VAS score were significantly reduced from 63.4±13.97 and 4.6±1.23 preoperatively to 7.8±4.67 and 1.3±0.76 at the final follow-up, respectively. Radius height, ulnar variance, volar tilt, radial inclination and wrist range of motion (flexion, extension, pronation, supination) were all significantly improved (p<0.001). Images showed good radius height, ulnar variance, volar tilt and radial inclination. The range of motion of wrist and forearm were improved substantially. Among 69 patients, two patients received allograft due to osteoporotic bone collapse. No serious complication was developed, except for minor pain in three patients during follow-up.

Conclusion: Open reduction through original fracture line and fixation with locking plate is a feasible and effective treatment for selective DRF malunion.

Citation: Bu G, Wei W, Li J, Yang T, Li M. Open reduction through original fracture line and fixation with locking plate is a feasible approach for extra-articular distal radius fracture malunion. Jt Dis Relat Surg 2022;33(3):489-495.

* The first two authors contributed equally to this manuscript.

Ethics Committee Approval

The study protocol was approved by the Ethics Committee of Tianjin Hospital (date: 20220307, No: 2022EIC007). The study was conducted in accordance with the principles of the Declaration of Helsinki.

Author Contributions

Provided input into the concept and design of the study, and provided the materials: G.B., W.W.; Collected and assembled the data: J.L., T.Y., M.L.; Analyzed the data: J.L., T.Y.; Carried out literature review: M.L.; Wrote the article: G.B., M.L.; All authors have critically revised the article, read and approved the final version at the time of submission.

Conflict of Interest

The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.

Financial Disclosure

The authors received no financial support for the research and/or authorship of this article.


Thanks to radiologist Lin Guo and Yi Cao for imaging measurement for this study.