Factors predicting late collapse of distal radius fractures.

Neritan Myderrizi Neritan Myderrizi

doi:10.5704/moj.1111.006

Abstract

Although fractures of the distal radius are a common clinical presentation, many factors affect instability of these injuries. The aim of this study was to assess the influence of age, sex, distal radial ulnar joint injury (DRUJ), ulnar styloid fracture, and dorsal displacement in late collapse of distal radius fractures. Three hundred twenty-nine patient fractures were measured for dorsal tilt, radial inclination and ulnar variance after reduction and 2 months later. Reduction loss was analysed statistically against variables like DRUJ involvement, ulnar styloid fractures, age, sex, and AO classification. After two months there was loss of reduction in 171(51.9%) cases. Loss of reduction was related to age, AO classification, involvement of DRUJ, ulnar styloid fractures and initial displacement. Factors such as age, associated DRUJ injury, ulnar styloid fracture are predictive of loss of reduction. Knowing these predictor factors, can aid in decision regarding treatment methods. Distal Radius Fracture, Radial Tilt, Ulnar Variance, Volar Tilt, Ulnar Styloid Fracture, DRUJ.

Highlights

The aim of this study is to investigate if loss of reduction after conservative treatment is significantly associated with age, sex, ulnar styloid fractures, AO classification and/or distal radial ulnar joint (DRUJ) involvement
There has been no consensus for treatment of distal radius fractures since 1814, when Abraham Colles described such fractures[1]
After two months there was loss of reduction in 171 cases. This loss was more obvious in fractures which were associated with distal radial ulnar joint injury (DRUJ) injuries (Table 2)

Summary

Introduction

There has been no consensus for treatment of distal radius fractures since 1814, when Abraham Colles described such fractures[1]. Trumble at al[2] reported loss of reduction a few weeks post initial treatment, despite excellent reduction in anatomic position This is an important problem because malunion of distal radius fractures can lead to posttraumatic arthritis, mid carpal instability and pain 3. The aim of this study was to assess the influence of age, sex, distal radial ulnar joint injury (DRUJ), ulnar styloid fracture, and dorsal displacement in late collapse of distal radius fractures. Conclusions: Factors such as age, associated DRUJ injury, ulnar styloid fracture are predictive of loss of reduction. Knowing these predictor factors, can aid in decision regarding treatment methods

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