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Preoperative images of a 32-year-old man left wrist with severe deformity. A, B, C, D: Pictures obtained on the date of injury. The patient sustained an open extra-articular distal radius fracture with large dorsal soft tissue defect type IIIB.
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Following the fixation of the fragmented fractures, myorrhaphy-tenorrhaphy on the injured tendons was done (Fig. 1).
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A: The patient's preoperative CT scans showing malalignment of the distal radius in both sagittal and coronal planes. A: The angle of volar inclination is 45   in sagital plane. B: CT scan with reconstruction in the coronal plane and C: in sagital plane. D, E: The first postoperative plain radiographs in a-p and lateral view showing deformity correction.
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CT images with 3D reconstructions were used for pre-operative planning (Fig. 3A-C) and corrective osteotomy and fixation with volar plate was planned.
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Postoperative follow-up.
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In order to have a better post operative evaluation, the objective measurements, examination of the wrist range of motion (ROM) and grip strength (with a dynamometer-Jamar) were done (Fig.4).
Final follow-up of a patient treated with palmar aproach, 20 months postoperatively. A, a-p view of the uninjured right wrist shows an ulna slightly minus variance. B. Lateral view of the normal uninjured right wrist. C, D. Postoperative X - rays of the left wrist showing complete healing of the left distal radius after corrective osteotomy and restoring proper anatomic parameters comparing to the normal right side.
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The quantification of these measurements show approximation of results with normal rates (Table 1) (Fig. 5).