Distal Radius Malunion Correction Without Bone Graft: A Systematic Review

This study reviews literature on corrective osteotomies without bone grafting for malunion of distal radius fractures (MDRF). A systematic review was performed on the treatment of MDRF without bone graft. The primary functional outcome measures were time to radiological union, Disabilities of the Arm, Shoulder, and Hand (DASH) scores, Visual Analogue Scale (VAS) scores, Mayo Wrist scores, grip strength, and range of motion (ROM) at final follow-up. A total of 285 patients across 11 studies met search criteria. Radiological union occurred in 98.9% of cases with a mean time of 3.9 months. Postoperatively, DASH improved an average of 25.9 points, VAS improved an average of 2.1 points, and Mayo Wrist improved an average of 34.3 points. A total of 133 complications (46.7%) were reported. Correction of MDRF without graft can produce excellent clinical outcomes, short time to union, and comparable complication rates to the bone grafting. (Journal of Surgical Orthopaedic Advances 35(2):091–094, 2026)

Key words: distal radius fracture, malunion, bone graft, corrective osteotomy, nonunion