Scaphoid malunion. The significance of rotational malalignment.

Three patients with painful malunions of the scaphoid and significant loss of active wrist extension were treated with an opening wedge multiplanar osteotomy that corrected flexion, ulnar deviation, and pronatory rotational malalignment of the distal fragment. After a minimum follow-up of 4 years, all three patients were satisfied with the procedure and were pain-free. The preoperative range of wrist motion had improved, and they had returned to their preoperative occupations.