Choosing the optimum method of treatment for extra-articular distal radius Colles' type fractures in adult: A retrospective cohort study

Abstract

Context: Distal radius fractures are often encountered in orthopedic outpatient department, mostly managed with a below-elbow cast though malunion is the commonest known complication. Many researches had already been conducted comparing cast with various surgical methods; however, conclusive results yet to be ascertained. While choosing the treatment, we retrospectively analyzed the results of different methods to reach a conclusion. Subjects and Methods: A total of 92 patients with unilateral extra-articular or partially articular distal radius fracture were analyzed retrospectively over a period of 2 years, 30 of which managed conservatively and 62 with various surgical techniques (plate 27, external fixation 24, and K-wires 11). Functional results were recorded by PRWE score and radiological union was assessed. Statistical Analysis Used: Unpaired t-test was used for numerical value and Chi-square test for categorical values, and analysis of variance was used for multiple comparisons among the groups. Results: PRWE pain score, PRWE functional score, and means of individual radiological parameters measurements did not show any significant association among the study groups, P > 0.05. However, Chi-square test of association showed a significant correlation between radiology and function, P < 0.001. Conclusions: There is no difference between surgical and nonsurgical methods as a whole so as to say which one is better, thus nonsurgical methods still hold a good option today and should be the first choice while dealing with such injuries. Anatomical reduction should always be tried irrespective of methods of treatment as excellent to good function was seen with undisplaced or minimally displaced or well-reduced fractures.