Corrective osteotomy for post-traumatic malunion of the phalanges in the hand

Rotation, angulation, deviation, shortening or a combination of deformities can occur due to phalangeal malunion and can lead to impairment of hand function. A historical cohort study of 57 patients who had phalangeal corrective osteotomies for posttraumatic malunion between 1978 and 1990 was undertaken. 59 rotational, radial/ulnar deviation, flexion/extension, length adjustment procedures, and combinations thereof were performed, using rigid internal fixation. Concurrent tenocapsulolysis was done in 50% of the cases. Satisfactory correction was obtained in 76% of the patients. Pony union was obtained in all cases. A net gain in active range of motion was achieved in 89% of the patients. Excellent and good results were obtained in 96% of the patients who had corrective osteotomies for malunion involving only the bone and in 64% of the patients who had corrections for malunion with involvement of multiple structures (P < 0.01).