Union with deformity is the most common complication following
a distal radial fracture1-5. The
deformity may be extra-articular, characterized by loss of length
and metaphyseal angulation; it may be intra-articular, involving
either the radiocarpal or the radioulnar joint, or both; or it may
be a combination of the two. Surgical treatment of a symptomatic malunion of the distal part
of the radius has been recognized for more than 200 years. Resection
of the distal aspect of the ulna for the management of pain at the
distal radioulnar joint after a distal radial fracture, a procedure
attributed to Darrach after his description in 19136, had been suggested by Desault in 17917 and again by Moore in 18808. In 1937, Campbell described a corrective
osteotomy of the distal part of the radius with use of an interpositional bone
graft obtained from the distal part of the ulna9.
In 1945, Merle d’Aubigné and Joussement described
a multiple-facet curved osteotomy without the need for an interpositional
bone graft10. This concept is
currently being revisited and will be described.