A percutaneous opening-wedge osteotomy for hand bone malunions

Objective To evaluate efficiency of a percutaneous opening-wedge osteotomy, realignment, and fixation for hand bone malunions. Methods From November 2020 to November 2023, the patients with hand bone malunions were treated. Fracture angulation was assessed on X-rays or CT scans. Range of motion of the digits was assessed based on the total active motion scale. The scales were graded as excellent (100%), good (75%–99%), fair (50%–74%), and poor (<50%) based on the total active motion. Results There were 47 patients (42 male and 5 female patients) with the mean age of 34 years (range, 17–58 years). The injured digits included thumb ( n = 10), index finger ( n = 6), long finger ( n = 7), ring finger ( n = 11), and little finger ( n = 13). The mean duration from injury to surgery was 16 weeks (range, 3–58 weeks). Bone healing was achieved in all patients after a mean of 6 weeks (range, 4–12 weeks). The mean follow-up period was 26 months (range, 24–29 months). The mean preoperative apex angulation of the fingers was 43° (range, 11°–68°), and the mean angulation at the final follow-up was 2° (range, 0°–6°). The mean preoperative apex angulation of the thumbs was 40° (range, 32°–54°), and the mean angulation at the final follow-up was 0° (range, 0°–5°). At the final follow-up, the mean total active motion scale was 257° (range, 116°–283°). There were 36 excellent and 11 good results. Conclusion Hand bone malunions can be treated with a percutaneous opening-wedge osteotomy, realignment, and fixation, resulting in good functional outcomes.