Volar osteotomy for malunited distal radial fracture (see text). A, Preoperative planning. B, Kirschner wire drilled into radial shaft proximal to osteotomy site. C, Small external fixator used to maintain corrected alignment. D, Osteotomy wedged open with lamina spreader. E, Iliac graft inserted and osteotomy stabilized with T-plate. (From Fernandez DL: Malunion of the distal radius: current approach to management, Instr Course Lect 42:99, 1993.) SEE TECHNIQUE 58.31.