Complex Fractures of the Distal Radius

Abstract

Outcome of complex distal radius fractures. Design: Retrospective clinical observation. Outcome assessment of a clinical series of patients with complex distal radius fractures treated according to a structured, stepwise treatment algorithm. 17 patients (average age 47 years) with mostly high-energy injuries, 16/17 articular fractures including concomitant carpal injuries, fracture dislocations, extension of the fracture into the diaphysis, and large defects. Initial external fixation, followed by soft tissue treatment and further diagnostics and, finally, definitive adapted surgical therapy including combination of external fixation, plates, screws, K-wires, bone graft, and ligament repair. DASH, range of motion, radiologic outcome. Average subjective overall performance score (DASH) 16.4 (0–36.7, standard deviation [SD] 11.82, 95% confidence interval [CI] 8.0–23.6), 73% of the patients back to premorbid work and activities. Using a clearly structured, stepwise approach, complex distal radius fractures can be treated with good clinical outcome preserving hand function.