Patient reported outcomes after corrective osteotomy for a symptomatic malunion of the distal radius

Aims: The primary aim of this study was to describe patient satisfaction and health-related quality of life (HRQoL) following this procedure.

Patients and Methods: We retrospectively identified 122 skeletally mature patients from a single centre over an 8-year period that had undergone corrective osteotomy for a symptomatic malunion of the distal radius. The primary long-term outcome was the Patient-Rated Wrist Evaluation (PRWE). Secondary outcomes included the QuickDASH, the EQ-5D-5L, complications and the Net Promoter Score (NPS). Multivariable regression analysis was used to determine factors associated with the PRWE.

Results: Long-term outcomes were available for 89 patients (72%). The mean age of the study cohort was 57 years (Standard Deviation [SD] 15 years) and 68 patients were female (76%). The median time from injury to corrective osteotomy was nine months (Interquartile Range [IQR] 6-13 months). At a mean follow-up of six years (range 1-11 years) the median PRWE was 22 (IQR 7-40), the median QuickDASH 11.4 (2.3-31.8) and the median EQ-5D-5L index was 0.84 (IQR 0.69-1). The NPS was 69. Multivariable regression analysis revealed that the presence of an associated ulnar styloid fracture was the only independent predictor of worse PRWE when adjusting for confounding variables (p=0.004).

Conclusions: This study has demonstrated that corrective osteotomy for malunion of the distal radius can result in good functional outcomes and high levels of patient satisfaction. However, the presence of an ulnar styloid fracture may negatively affect function.