Surgical Description of the Langenskiöld Procedure

Incision distal over the tendons of the long digital extensor muscle. Separation of the subcutaneous tissue between the extensor tendons onto the distal radius. The distal radius is exposed subperiosteal on the ulnar side. An osteotomy is performed of the distal radius on the ulnar side up to the abnormal physis. The epiphysis is left in place. The bone just proximal is removed until normal physis is seen over the entire width. Vickers’ ligament is identified and released. The spongiose part of the radius is sealed with bone-wax, except the part close to the physis. The physis is covered using a fat-interposition from the subcutaneous fat. Closure is achieved in layers and a forearm-cast applied post-operatively.