Figure 1441107x

Figure Legend: Distal radius nonunions are uncommon, but usually symptomatic due to progress of angulation and symptoms from distal radial ulnar joint disruption.  This patient developed progressive angulation and hardware failure following dorsal plating of a Galeazzi type metaphyseal distal radius fracture dislocation (1, 2).  The original surgeon should have used a more sturdy plate and should have captured more cortices proximally.  At exploration, soft tissue interposition was found in the fracture line, and the extensor pollicis longus tendon was on its way to an attritional rupture, positioned behind the plate (3).  The fracture was reduced, stabilized with a 3.5mm plate and cerclage, and the distal ulna was used as bone graft (4).
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