# Forearm rotation improves after corrective osteotomy in patients with symptomatic distal radius malunion

## TL;DR

Corrective osteotomy improves forearm rotation and other hand functions in patients with distal radius malunion.

## Contribution

Demonstrates that corrective osteotomy significantly improves forearm rotation and related outcomes in patients with distal radius malunion.

## Key findings

- Forearm rotation improved from 112° preoperatively to 142° at 12 months post-surgery.
- Pronation and supination both showed significant improvement after corrective osteotomy.
- Grip strength, pain, and patient-reported outcomes also improved significantly.

## Abstract

Distal radius malunion can result in pain and functional complaints. One of the functional problems that can affect daily life is impaired forearm rotation. The primary aim of this study was to investigate the effect of corrective osteotomy for distal radius malunion on forearm rotation at 12 months after surgery. We secondarily studied the effect on grip strength, radiological measurements, and patient-reported outcome measurements (PROMs).

This cohort study analysed prospectively collected data of adult patients with symptomatic distal radius malunion. All patients underwent corrective osteotomy for malunion and were followed for 1 year. We measured forearm rotation (pronation and supination) and grip strength and analysed radiographs. PROMs consisted of the Patient-Rated Hand/Wrist Evaluation (PRWHE) questionnaire, Visual Analogue Scale for pain, and satisfaction with hand function.

Preoperative total forearm rotation was 112° (SD: 34°), of which supination of 49° (SD: 25°) was more impaired than pronation of 63° (SD: 17°). Twelve months after surgery, an unpaired Student's t-test showed a significant improvement of total forearm rotation to 142° (SD: 17°) (p < 0.05). Pronation improved to 72° (SD: 10°), and supination to 69° (SD: 13°) (p < 0.05). Grip strength, PROMs, as well as inclination and volar tilt on radiographs improved significantly during the first year after surgery (p < 0.05).

In patients with reduced forearm rotation due to distal radius malunion, corrective osteotomy is an effective treatment that significantly improves forearm rotation. In addition, this intervention improves grip strength, the PRWHE-score, pain, and satisfaction with hand function.

•Distal radius malunion can result in symptomatic limitation in forearm rotation, affecting patients' daily activities.•Forearm rotation is an essential function, especially in today's digital age where activities like using a mobile phone or keyboard are important.•In patients with reduced forearm rotation due to distal radius malunion, corrective osteotomy is an effective treatment to improve this function.

Distal radius malunion can result in symptomatic limitation in forearm rotation, affecting patients' daily activities.

Forearm rotation is an essential function, especially in today's digital age where activities like using a mobile phone or keyboard are important.

In patients with reduced forearm rotation due to distal radius malunion, corrective osteotomy is an effective treatment to improve this function.