Forearm contracture complicated by Malunion of Distal Radius Ulna Managd by DerotationalOsteotomy Combined with Pronator Teres Lengthening and Pronator Quadratus Release

Abstract

Forearm region has complex anatomical and functional unit with unique osseous, soft tissue, articular composition, and adjacent structure. Trauma and injury of this complex biologic forearm may impact functional system significantly leading to pain, instability either proximal or distal radioulnar articulation, and impair or limit the range of motion. Corrective osteotomy for malunion fracture or other posttraumatic deformities of the forearm region are challenging procedure caused by unique anatomy especially three main nerves down the forearm to the wrist hand.  This case present 48-year-old male patient who was referred to Sanglah Hospital with left forearm contracture, malunion in left distal os. Radius, and malunion lest distal os. Ulna.  Patient was treated with pronator teres lengthening, pronator quadratus release, DRUJ release, deretational osteotomy, ORIF PS, Transfixing wire, and immobilization with backslab. Improvement of clinical manifestation was successfully achieved with minimal surgery complication.