Malunited Distal End Radius with Garden Spade Deformity and Distal Radioulnar Synostosis: A Case Report of a Quirky Wrist

Abstract

Distal end radius fractures are the most common type of wrist fracture and a significant complication associated with these injuries is malunion, which can lead to deformities that adversely affect the normal biomechanics of the wrist joint. Failing to address this malunion may result in chronic pain, a reduced range of motion and early-onset arthritis of the wrist joint. Therefore, it is essential to correct this malunion surgically, as doing so can greatly enhance functional outcomes for patients and improve their overall quality of life. Hereby authors report a rare case of a malunited distal end radius fracture with garden spade deformity and distal radioulnar synostosis. Upon presentation, the patient had a fixed wrist flexion deformity of 40° and a fixed pronation deformity of 20°. The patient was managed with corrective osteotomy of the malunited distal end radius, distal ulna excision and resection of the distal radioulnar synostosis. The preoperative measured volar tilt angle of 49.3° was corrected to 18.6°. At one year follow-up, the patient’s QUICK DASH score improved from 50% (severe disability) to 11.4% (minimal disability) and the modified Mayo wrist score improved from a score of 35 (poor) to 80 (good).

Keywords

• orthopaedic procedures
• osteotomy
• radius fractures
• wrist joint