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Distal Radius Fractures and Malunions

Distal Radius Fractures and Malunions

Fractures of the distal radius represent approximately 15% of all adult fractures, and a significant number of these require surgical management. Surgical treatment options for an acute fracture include pinning, plating, or external fixation. In some cases, bone grafting may be required.


A fracture malunion can occur if the bone heals in a non-anatomic position. This can occur for several reasons: a patient who required surgical treatment who was not able to have surgery due to other circumstances; or a fracture that was treated without surgery heals incorrectly; or when a surgically treated fracture collapses.

List of Physicians Who Treat Distal Radius Fractures and Malunions

It is important to find a physician who has specialized training in caring for all conditions of the hand, wrist and forearm, ranging from acute, limb-threatening injuries to chronic, degenerative diseases.

For details about education, experience, and specialty in this clinical area, please visit these physician profile pages:

Scheduling an Initial Consultation

If you are considering treatment, the first step is to schedule an initial consultation with a plastic surgeon. To schedule an appointment at the University of Michigan Hand Clinic, please call (734) 998-6022.

What to Expect During the Initial Consultation

Depending on the complexity of your condition, you may visit with more than one physician, surgeon, therapist, or physician extender. You should plan on your consultation lasting between 1-2 hours. During this important visit, you should expect:

  • To provide a complete medical history, including information about previous surgical procedures; past and present medical conditions; and any medications or herbal supplements you are taking.
  • To undergo a physical examination.
  • To discuss possible options for treatment of your condition, including whether surgery is recommended.
  • To discuss in detail the surgical procedure recommended; the recovery and rehabilitation period, and the probable outcome in terms of function and appearance.
  • To discuss possible risks and complications of the procedure.
  • To ask your surgeon if there is anything about the procedure you don't understand.

Hand Therapy and Rehabilitation

Treatment plans are tailored to fit your condition, living and work requirements. The ultimate goal is the restoration and optimization of your hand function, renewed independence and overall quality of life.

Whether as a non-surgical option or to enhance your recovery from hand surgery, the plastic surgeon may recommend a course of rehabilitation (physical and occupational therapy) under the direction of a trained hand therapist. Hand therapy is provided on site at the University of Michigan's Hand Center by our team of Occupational and Physical Therapists. Referrals can be arranged closer to your home when that is more convenient.

Preparing for Your Surgery

If your plastic surgeon recommends surgery to treat the condition, you'll work with the Hand Center scheduling nurse to set a date for the operation. You will be given a pre-operative information packet that explains everything you should do and know before your surgery date. Your surgeon will give you specific instructions on how to prepare for surgery, including guidelines on eating and drinking, smoking, and taking or avoiding certain vitamins and medications. You should arrange for someone to drive you home after your surgery, and to help you out at home for a day or two.

Where Your Surgery Will Be Performed

The majority of these procedures are completed on an out-patient basis. Your procedure will take place at the University of Michigan Hospitals, which provide state-of-the-art surgical suites and recovery areas.

Types of Anesthesia

In some cases, general anesthetic is not necessary. Your surgeon will discuss the best anesthetic options to make you feel comfortable and relaxed during the procedure, including local anesthesia in your hand and/or an anesthetic block near the shoulder. Keep in mind anesthetics can have side effects such as nausea, drowsiness, depression and confusion.

After Your Surgery

Click here for information about how to care for yourself after the surgery and what to expect during your recovery. It is very important that you follow your surgeon's instructions. Your post-operative rehabilitation may include hand exercises, heat and massage therapy, electrical nerve stimulation, splinting, traction, and special wrappings to control swelling. Keep in mind that surgery is just the foundation for recovery. It's crucial that you follow the therapist's instructions and complete the entire course of therapy if you want to regain the maximum use of your hand. Also, remember that you may be one handed for up to six to eight weeks after your procedure. This can affect your ability to dress yourself, cook, clean, bathe or drive. Consider having someone with you during your recovery period.

For adult appointments, please call 734.998.6022