TO COMPARE THE OUTCOME OF FRACTURES OF DISTAL END OF RADIUS TREATED CONSERVATIVELY WITH IMMOBILIZATION IN PALMARFLEXION AND DORSIFLEXION

Abstract

Fractures of the distal end radius represent one-sixth of all fractures of the human skeleton1 treated in emergency department. Closed reduction and cast immobilization has been the mainstay of treatment of these fractures. Restoration and maintenance of anatomy correlates well with function.5Distal radius fractures are easy to reduce closed when the fractures are recent and the hematoma has not yet organized. All stable distal radial fractures can be treated with closed manipulation and below elbow cast with wrist in slight dorsiflexion. The crux to restoration of normal anatomy and best hand function lies with selectively flexing the dorsally displaced fracture fragment without flexing the carpals. According to the John Charley,10,12 colle’s fracture should be treated in palmar flexion and ulnar deviation as dorsal periosteal hinge provides stability. Traditionally extra-articular fracture of the distal end of radius were classically treated by closed reduction, cast immobilization in palmar flexion and ulnar deviation. But few studies have showed, higher chance of redisplacement with this conventional position. Ajay Gupta11 reported on treatment of colle’s fracture comparing immobilization of the wrist in palmar flexion, neutral position and dorsiflexion. He concluded that immobilization of the wrist in dorsiflexion appears to provide better maintenance of reduction. Fractures immobilized with the wrist in dorsiflexion showed the lower incidence of redisplacement, especially of dorsal tilt and had the best early functional results.In the past, very few studies have compared the results depending on the position of immobilization. Thus we decided to compare the outcome of fracture of the lower end of radius immobilsed in traditional palmar flexion and ulnar deviation and dorsiflexion.