TechniquesExtra-articular Corrective Osteotomy With Bone Grafting to Achieve Lengthening and Regain Alignment for Distal Radius Fracture MalunionHuang, Hui-Kuang MD*,†,‡,§; Hsu, Shiuan-Hau MD‡; Hsieh, Feng-Chi MD‡; Chang, Kai-Hui MD‡; Chu, Heuy-Ling MD∥; Wang, Jung-Pan MD, PhD*,† Author Information *Department of Surgery, School of Medicine, National Yang-Ming University †Department of Orthopaedics & Traumatology, Taipei Veterans General Hospital, Taipei ‡Department of Orthopaedics, Chiayi Christian Hospital, Chiayi §Chung Hwa University of Medical Technology ∥Chia Nan University of Pharmacy and Science, Tainan, Taiwan This study was approved by Institutional Review Board of Chiayi Christian Hospital (IRB number: 2018063). Conflicts of Interest and Source of Funding: The authors report no conflicts of interest and no source of funding. Address correspondence and reprint requests to Jung-Pan Wang, MD, PhD, Department of Orthopaedics & Traumatology, Taipei Veterans General Hospital, 201, Sec. 2, Shih-Pai Road, Taipei 112, Taiwan. E-mail: [email protected]. Techniques in Hand & Upper Extremity Surgery 23(4):p 186-190, December 2019. | DOI: 10.1097/BTH.0000000000000252 Buy Metrics Abstract Surgical correction of the distal radius fracture malunion is challenging because of the 3-dimensional deformity. We propose a method by using the Kapandji intrafocal pinning in corrective osteotomy for treatment of the distal radius fracture malunion to facilitate the alignment correction while using the bone graft to restore the radial length. The surgery was started with the osteotomy from a volar approach, and the osteotomy gap was expanded gradually. Then, allobone grafting was performed to maintain the corrected radial length. We used the Kapandji intrafocal pinning dorsally to provide dorsal supporting force and radially to correct the radial inclination. Finally, a volar plate was used to buttress and push the distal fragment to fit as to regain the correct volar tilt. We enrolled 10 patients of distal radius fracture malunion with a mean age of 59.3 years. All patients had bone healing within 3 months after surgery. The mean lengthened distance was 5 mm. The radial inclination and volar tilt could be corrected with improved functional results. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.