Reply to the Editor

Abstract

Re: Wu CC. A novel surgical approach for treating distal radial extraarticular malunion: Oblique osteotomy with buttress plate stabilization. J Orthopaedic Surgery, published May–Aug 2017, 25(2). DOI: 10.1177/2309499017714087

Dear Sir,

Many thanks for your zealous comments. Treatment of distal radial malunion may use a number of techniques.^1,2 However, advantages and disadvantages of each technique may be supported by individual orthopedic surgeon. Dr Thivaios presented a sliding osteotomy technique from antero-proximally to postero-distally.³ Practically, it is still an oblique osteotomy. My oblique osteotomy technique is from medio-distally to latero-proximally.⁴ The advantages are (1) easily applying a bone clamp for assisting lengthening; (2) concomitantly correcting distal radioulnar diastasis; (3) resected bone fragments being used for bone graft; and (4) osteotomy area being widely exposed whenever necessary. You had concerned that osteoporosis may hinder bone clamp function during lengthening. I think that it will not cause a real trouble. Under this situation, you can pull the patient’s wrist distally for assisting lengthening while a bone clamp is compressing.⁴ I had never met any lengthening trouble in all my patients. The adhesive soft tissues are manipulated gently and released with cauterization if necessary. Finger function is preserved with simply immobilization of the wrist using a wrist brace for 6 weeks.

Chi-Chuan Wu Chang Gung University, Taoyuan Corresponding author: ccwu@mail.cgu.edu.tw

References

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. Corrective osteotomy is an effective method of treating distal radius malunions with good long-term functional results. Injury 2017; 48(3): 731–737.

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. Sliding osteotomy for deformity correction following malunion of volarly displaced distal radial fractures. J Orthop Trauma 2003; 17(5): 326–333.

. A novel surgical approach for treating distal radial extraarticular malunion: Oblique osteotomy with buttress plate stabilization. J Orthop Surg (Hong Kong) 2017; 25(2): 2309499017714087. DOI: 10.1177/2309499017714087.