Isolated Ulnar Shortening Osteotomy for a Distal Radius Malunion in a Young Female - A Cosmetic and Functional Success Story

Sep 30, 2026

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Distal radius malunions are common after conservatively treated wrist fractures, often causing deformity, pain, and reduced function. This case describes a 20-year-old woman presenting three years after a distal radius fracture with dorsal tilt, radial shortening, and +4 mm positive ulnar variance, while the distal radioulnar joint (DRUJ) remained congruent. An isolated ulnar shortening osteotomy resecting a 1 cm bone wedge was performed. At one year, imaging showed union with corrected ulnar variance and she achieved full, pain-free range of motion, full grip strength, and high satisfaction with cosmetic and functional outcomes.

LanguageEnglish

CategoryHealthcare

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Case Report Journal of Orthopaedic Case Reports 2025 December:15( 12) :Page 208-211 Isolated Ulnar Shortening Osteotomy for a Distal Radius Malunion in a Young Female: A Cosmetic and Functional Success Story Burhanuddin F Chhatriwala1, Aibin B Michael1, SuyogWagh1, V S Sri Hari Ram1, Priyanka Meena2 Learning Point of the Article: Isolated ulnar shortening osteotomy is a viable alternative to distal radius osteotomy in appropriately selected patients with radial shortening and intact DRUJ anatomy. Abstract Introduction: Distal radius malunions are common complications of conservatively treated wrist fractures, often presenting with pain, deformity, and functional limitations. While corrective distal radius osteotomies are standard, isolated ulnar shortening osteotomy (USO) may offera simpler alternative in select cases, particularly where radial shortening and positive ulnar variance are the primary issues. Case Report: We report the case of a 20-year-old female who presented 3 years after a conservatively treated distal radius fracture. Her complaints includedwrist deformity, reduced grip strength, and intermittent pain. Imaging revealed a distal radius malunion with dorsal tilt and radial shortening, resulting in a positive ulnar variance of +4 mm, while the distal radioulnar joint (DRUJ) remained congruent. Surgical intervention involved an USO, during which a 1 cm wedge of bone was resected. At 1-year follow-up, she demonstrated excellent range of motion, full grip strength, nopain, and was highly satisfiedwith the cosmetic outcome. Conclusion: In selected cases of distal radius malunion with radial shortening and preserved DRUJ congruity, isolated USO can be an effective surgical solution to address both cosmetic and functional concerns. Keywords: Distal radius malunion, ulnar shortening osteotomy, cosmetic deformity correction, grip strength restoration, joint preservation surgery. Introduction Distal radius fractures are among the most commonly encountered upper limb injuries,particularly in young adults and the elderly. Inadequate reduction or improper immobilization may result in malunion, leading to mechanical and functional impairment. These malunions may present with loss of wrist motion, pain, weakness in grip, or unsightly deformity. Conventionally, corrective distal radius osteotomy i s the preferred intervention in such cases, aiming to restore normal anatomic alignment. However, recent literature has highlighted the importance of evaluating the distal radioulnar joint (DRUJ) in the context of distal radius malunions, as dysfunction of this articulation can significantly influence outcomes [1, 2]. When DRUJ congruity is maintained and the primary deformity is positive ulnar variance due to radial shortening, isolated ulnar shortening osteotomy (USO) has been reported as an effective and less invasive alternative [3]. We present a case where isolated USO was successfully used to treat a young woman with a distal radius malunion, addressing |
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Website: [www.jocr.co.in](www.jocr.co.in)

DOI:
[https://doi.org/10.13107/jocr.2025.v15.i12.6510](https://doi.org/10.13107/jocr.2025.v15.i12.6510) | Author’s Photo Gallery | | | | | | --- | --- | --- | --- | --- | --- | | | | | | | | | |
1Department of Orthopaedics, Lokmanya Tilak Municipal Medical College and General Hospital, Mumbai, Maharashtra, India, 2Department of Orthopaedics, GMC Mumbai ( JJ Hospital), Mumbai, Maharashtra, India.
Address of Correspondence:
Dr. Burhanuddin F. Chhatriwala,
Department of Orthopaedics, Lokmanya Tilak Municipal Medical College and General Hospital, Mumbai, Maharashtra, India. [E-mail:](E-mail: burhan110128@hotmail.com)[ burhan110128@hotmail.com](E-mail: burhan110128@hotmail.com) | | | | | | Submitted: 12/09/2025; Review: 09/10/2025; Accepted: November 2025; Published: December 2025 | | | | | | | DOI: [https://doi.org/10.13107/jocr.20

FAQs

Why is DRUJ evaluation important in distal radius malunion cases?

DRUJ dysfunction can significantly influence clinical outcomes. When DRUJ congruity is maintained, surgical choice can be tailored to the primary deformity.

What were the key findings in the reported patient’s imaging?

The patient had a distal radius malunion with dorsal tilt and radial shortening, producing a positive ulnar variance of +4 mm, while the DRUJ remained congruent.

What surgical approach was used and what were the 1-year results?

An isolated ulnar shortening osteotomy was performed with resection of a 1 cm bone wedge. At one-year follow-up, radiographs confirmed union and she had full, pain-free wrist motion, full grip strength, and high satisfaction with cosmetic and functional results.

Sep 30, 2026

Uploaded by dabgoudw