A less invasive distal osteotomy of the radius for malunited dorsally displaced extra-articular fractures.

A less invasive corrective osteotomy for symptomatic post-traumatic deformity of the distal radius was done in 12 patients. They were followed up for an average of 3.7 years. The indications for correction were based on the patients' level of activities, pain, functional limitations, loss of grip strength or deformity occurring with an extra-articular rotational malunion of the distal end of the radius. The procedure included a dorsal open wedge osteotomy through a dorsal incision in which the fulcrum of rotation, or hinge, was located at the palmar cortex, and stabilized with an extra- and intramedullary fixed angle device. The bone defect was replaced with autologous morsellized iliac bone graft. The final outcome was graded as very good in eight patients, good in two and fair in two. Level of evidence: IV.

Autologous osteochondral graft for traumatic defects of finger joints.

Finger joint defects in 16 adults were treated with an autologous osteochondral graft from the base of the second metacarpal, the radial styloid, the base of the third metacarpal or the trapezoid and these patients were followed up from between 12 and 62 months. There was no donor site morbidity. One patient had resorption of the graft and developed pain. The joint was subsequently fused. The mean range of movement was 55.8% of the opposite normal joint. At follow up, 15 patients had no discomfort or mild discomfort. Three had mild narrowing of the joint space and two had slight joint subluxation. Only two patients with concomitant severe injury to the same limb had difficulty performing daily activities. Ten were open injuries and these had poorer outcomes. A hemicondylar defect of a finger joint can be treated using an osteochondral graft obtained from the same hand.