Malunion Distal Radius- Ulna-Plus 2.1mm
I would like to discuss the following case:
37yo dentist, right hand dominant, very active in sports (mountain biking, cross country skying skating style, swimming), quite unsensitive to pain.
On july 16th hyperextension injury. Treated himself with a removable orthosis. Started 12 days post injury with undemanding patient treatments, one week later with normal procedures.
Complains now reduced pronation and supination combined with stinging ulnar sided pain especially in pronation.
ROM E/F 50/0/50 R/U 15/0/25 P/S 70/0/65 (painful)
Radiographs taken 4 weeks post injury show a distal radius fracture with shortening of the radius by 2.2mm in relation to the ulna.
He is about to start a practice on his own within the next quarter to half a year. He is very concerned because of the upcoming new task.
What would you recommend?
Especially: what would you do standing in his shoes?
Do corrective osteotomy as soon as possible or wait and see how he gets along?
I tend to let him heal and wait how his complaints develop.
Thank you for sharing your opinion!
Andrea A. Tandara
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Dr. Andrea A. Tandara
Consultant Surgeon of the Hand
European Diploma of Handsurgery (FESSH)
Department of Surgery
Heidelberg University Hospital
Im Neuenheimer Feld 110
Please find attached files