Abstract
To the Editor,
We read with interest the paper by Wu. 1 Distal radial malunion is a difficult problem and presents a clinical and management challenge. 2 The author is to be complimented for providing an easy surgical solution for correcting the complex malalignment of this malunion. He has done an oblique osteotomy and slid the distal fragment by compressing using bone clamp at the site of osteotomy. This compression by bone clamp is likely to work better if the malunion is nascent and the bone quality is good. We have reservation of using this method if the patient is old with osteoporosed bone. The osteotomized bone is likely to crumple rather than getting slid forward. Moreover, soft tissue contracture can develop in mature malunion cases, requiring release of soft tissue structures like pronator quadratus, brachioradialis and extensor tendons. 2 –5 The other paper based on similar surgical principle of sliding osteotomy does distraction of distal fragment by ‘initially using a small osteotome as lever followed by a small lamina spreader to allow creep of the soft tissue’. 6