Ulnar Styloid Research Articles

Surgical treatment of acute distal radioulnar joint instability associated with distal radius fractures.

This study investigates the question of whether open repair of acute distal radioulnar joint instability at the time of volar plating of distal radius fractures would enable early mobilization of the wrist without the risk of distal radioulnar joint instability. We evaluated 29 patients of mean age 53 years with a distal radius fracture and acute distal radioulnar joint instability who underwent volar plating of the radius combined with surgical repair of the triangular fibrocartilage complex or an ulnar styloid base fracture, followed by active motion exercise of the wrist at 1 week after surgery. At 1 year after treatment, all patients had a stable distal radioulnar joint and grip strength averaged 90% of the normal side. This study demonstrates that surgical repair of the triangular fibrocartilage complex or ulnar styloid fracture followed by early mobilization did not result in distal radioulnar joint instability, and suggests that the surgical treatment of distal radioulnar joint instability may permit early mobilization of the wrist in patients who are considered suitable for rapid rehabilitation after surgery. Type of study: Therapeutic Level IV.

Fixing fractures of the ulnar styloid in distal radius fractures

The majority of distal radius fractures are associated with an ulnar styloid fracture [1-3]. There is solid evidence in the literature that this association may ultimately affect the clinical outcome causing instability, disability, and pain in the distal radioulnar joint (DRUJ) [2,4-7]. The main reasons for the worse outcome are: (1) DRUJ instability, (2) impingement with the triquetrum, and (3) Extensor Carpi Ulnaris (ECU) tenosynovitis. Because of its close association with the Triangular Fibrocartilage Complex (TFCC), fractures of the ulnar styloid might indicate possible TFCC disruption with subsequent DRUJ instability [4,8,9]. Studies on the clinical relevance of ulnar styloid fractures have produced conflicting results. However, when considering size and displacement of the fracture, May et al [2] found that, after distal radius fracture stabilization, a fracture through the base of the ulnar styloid that involves most part of the TFCC attachment and stays in a deviated more radial position (2 mm or more) indicates DRUJ instability. In an ulnar styloid fracture model, Shaw et al [4] found that K-wire fixation of the ulnar styloid fracture restored stability to the DRUJ regardless the integrity of other supporting structures. Bone fragments resulting from non-union could also provoke irritation and pain [5,10] due to impingement with the triquetrum [11]. Twenty-six percent of ulnar styloid fractures develop non-union [12]. From those, just a few becomes symptomatic [5]. If the DRUJ is stable, simple removal of the fragment usually solves the problem [5,11]. Extensor carpi ulnaris tendon impingement caused by malalignment of a fibrous nonunion may also be responsible for a poor clinical outcome. [13,14]. This condition is rarely found after a distal radius fracture and it is successfully treated with excision of the bony prominence and reconstruction of the floor of the sixth compartment. Hence, fixation of a small sized ulnar styloid in the acute setting of a distal radius fracture is probably unnecessary. As the results of treatment of chronic instability of DRUJ following a distal radius fracture are more unpredictable [4], it is advisable to take all measures in the acute setting to prevent this complication. Therefore, fixation of the ulnar styloid is indicated when there are large sized fragments that persist deviated after stabilization of the radius or when the distal radioulnar joint is grossly unstable. Immobilization with a sugar tong splint for four weeks or until proper healing is necessary when the surgeon chooses not to fix a reduced ulnar styloid large fragment that is acceptably reduced.

Ignore fractures of the ulnar styloid in distal radius fractures

Fractures of the ulnar styloid frequently accompany fractures of the distal radius, however, there is no conclusive evidence whether it influences the final outcome of the treatment. The majority of studies show no negative effect of ulnar styloid fractures on final outcome, when the fracture of the distal radius is fixed, preferably by a locking plate [1,2]. Some authors, however, report on frequent non-unions of the ulnar styloid, distal radio-ulnar joint (DRUJ) instabilities, triangular fibrocartilage complex (TFCC) tears, and other complications which may cause ulnar wrist pain, reduced mobility and power of the hand [3,4]. No studies are available that address this issue for K-wire fixation of the distal radius fractures.

Fracturas del radio distal: encuesta sobre preferencias de manejo y tratamiento

PurposeDistal radius fracture (DRF) is a common injury at any age, and treatment is still controversial. The aim was to determine current trends of managing DRF among hand surgeons. MethodsA single electronic questionnaire was e-mailed to members of the Spanish Society of Hand Surgery (SECMA). Participants were asked for their preferences regarding classification, conservative and surgical treatment of these fractures. Their results are compared with current scientific evidence on this. ResultsA total of 49 SECMA members completed the questionnaire (14.41%). Most of them had over 21 years of experience as hand surgeons. The AO-ASIF classification was the most used. Stable DRF was treated conservatively with plaster, excluding the elbow. The surgical treatment of choice was open reduction and internal fixation with volar plates and screws. The arthroscope was not used routinely as reduction assistant, and instability of the distal ulnar joint is treated by fixation with transfixing pins or screw fixation of the ulnar styloid. No consensus was found as regrards bone supplements and biological treatment of osteporosis. Decision making is by their personal experience and knowledge acquired during their working life. ConclusionsDRF management varies depending on the experience of individual surgeons, and does not necessarily correlate with the published scientific evidence. Management is heterogeneous and larger studies and standard protocols are needed for the management of these injuries.

Fragment-specific fixation of complex distal radial fractures with small intraarticular fragments; volar locked plate augmented with Kirschner wires

Background: Complex intraarticular distal radial fractures associated with small articular fragments or distal radioulnar instability are difficult to treat and have a worse prognosis because of their potential for incongruity and arthrosis of the radiocarpal and distal radioulnar joints. Although treatment of these fractures has improved over the past decade, there is no single implant or technique that is appropriate for treatment of all fractures. Methods: From 2007–2010, 29 patients with 31 complex distal radial fractures (AO type C) with intraarticular fragments (two fractures were bilateral) were treated with open reduction and internal fixation with volar locked plate augmented with Kirschner wires. Results: After a mean follow-up of 30 mo (range: 28–36 mo), 87% of the patients were satisfied with the treatment and resumed their preoperative activities. According to Gartland and Werley clinical and radiographic scoring system, excellent results were achieved in 13 fractures (42%), good results in 14 (45%), fair results in three (10%), and a poor result in one (3%). Conclusions: We concluded that, although volar plating is a good treatment modality for treatment of complex distal radial fractures, it should be augmented with Kirschner wire fixation outside the plate in fractures with small fragments of the radial styloid, lunate or sigmoid fossa and in fractures that have associated distal radioulnar joint instability or displaced ulnar styloid fracture.

Assessment of segmental arm soft tissue composition in breast cancer-related lymphedema: a pilot study using dual energy X-ray absorptiometry and bioimpedance spectroscopy.

Changes in arm soft tissue composition, especially increased adipose tissue, has been found in advanced, non-pitting breast cancer-related lymphedema (BCRL). The aim of this study was to examine whether these changes were localized to any particular region of the arm and whether they occurred in lymphedema which still pitted to pressure. Secondary aims were to explore relationships between arm segment volumes, bioimpedance spectroscopy (BIS) measurements of extracellular fluid (ECF), and dual-energy X-ray absorptiometry (DXA) measurements of tissue composition. Nine women with unilateral BCRL participated. The dominant arm was affected in 4 women, and all presented with lymphedema that pitted to pressure. Arm volume was calculated from circumferences by the truncated cone method, ECF was determined with BIS and fat and lean tissue content measured by DXA. BIS and DXA measurements for women with lymphedema were made of the whole arm and also of four 10 cm-segments measured from the ulnar styloid at the wrist. Whole arm DXA data were compared to those of 45 women of similar age and body mass index without lymphedema. All women with lymphedema had a significantly larger absolute fat mass in their affected arm compared to their unaffected arm, (median difference between arms 146.9 g). The forearm segment 10 - 20 cm proximal to the wrist had the highest median inter-limb fat difference of all four arm segments. The soft tissue composition changes associated with BCRL may occur in the presence of pitting and predominantly affect the proximal forearm.

Triangular Fibrocartilage Complex Injury in Professional Cricketers

ABSTRACT Triangular fibrocartilage complex (TFCC) is a complex of multiple ligaments and cartilages at the ulnar end of the wrist. Injury of TFCC is commonly seen in sportsmen such as tennis players, cricketers, golfers and gymnasts. The typical presentation is pain radiating along the ulnar side of the hand, and is often accompanied by fracture of the ulnar styloid. Despite being a common injury, its knowledge remains largely unknown. This leads to a huge number of cases remaining undiagnosed and thus untreated and unreported. The authors report a TFCC injury in a professional Cricketer in an attempt to create awareness of this common sports injury. How to cite this article Talib U, Saleem S. Triangular Fibrocartilage Complex Injury in Professional Cricketers. J Postgrad Med Edu Res 2015;49(4):204-208.

Effect of ulnar styloid fracture on functional outcome of Colle's fractures: a comparative analysis of two groups

Background: The negative impact of ulnar sided injuries on distal radius fractures has opened another field of research and is gaining more attention. The aim of our study is to assess the impact of ulnar styloid process fracture on functional outcome of distal radius fractures managed conservatively. Methods: Radiological and Medical records of 150 patients of distal radius with and without styloid process fractures were retrospectively reviewed. Fractures were classified as per Frykman’s classification and patients were assessed for pain, grip and range of motion in addition to other parameters in Mayo’s wrist score. The instability at distal radioulnar joint was evaluated and compared in two groups. Results: There was a measurable difference in motion, strength, pain, or functional scores between the two groups. Mean mayo score at final follow up in Group I was 90±5 and in Group II was 80±4 and the difference was statistically significant (P value <0.05). DRUJ instability was noted in 20 % of patients in Group II and most of them were symptomatic. Conclusions: We conclude that presence of a fracture of ulnar styloid process with distal radius fracture results in a weak and painful wrist in a significant number of patients. They should be dealt more vigorously and managed effectively to prevent disabling distal radioulnar joint instability.

An Exceptional Case of Bilateral Radiocarpal Dislocation with Fracture of the Radial Styloid Associated to a Tiered Trauma of the Upperlimb

Radiocarpal dislocation is a particular entity, infrequent, representing only 0.2% of all dislocationsas evidenced by the scarcity of publications, which mainly affects young patients, and most often the result of violent trauma. We reported a case of a 35-year-old male patient who sustained dorsal radiocarpal dislocation after a fall from a high place, with fracture of the radial and ulnar styloid process in both wrists, associated to a tiered trauma of the right upperlimb. He was treated with closed reduction and immobilized by cast for the bilateral radiocarpal dislocation, and treated surgically for the tiered trauma of the upperlimb. The evaluation at 3 months showed favorable results. This case is one of the few similar cases reported because it is an uncommon pathology and it is even less frequent because the injury involves both wrists and the upperlimb.

Epidemiology and Seasonal Variance of Incidence of Distal Radius Fractures

Purpose: Fracture of the distal radius is one of the most common fractures encountered in the emergency room. The incidence of distal radius fracture has increased substantially according to several studies that estimated the overall incidence in various general populations. However, there is a paucity of epidemiological data regarding distal radius fracture in Korea. The aim of this study was to estimate the epidemiology and seasonal variance of incidence of distal radius fractures in the Korean population. Materials and Methods: Medical records and radiographs of the 432 patients who visited the emergency room for distal radius fractures from January 2012 to December 2013 were reviewed retrospectively. Authors analyzed the epidemiologic parameters including age, gender, injury mechanism, fracture classification, combined fracture, treatment method and monthly incidence. Results: The mean age of the patients at the time of injury was 53 years (41.6 years in 171 men, 64.5 years in 261 women). The highest incidence in age distribution was the sixth and seventh decade (45.2%) and male to female ratio was 1.0:2.5. Most fractures (78.4%) were caused by a lower energy fall and the most common combined fractures were the ulnar styloid fracture (38.6%). According to the AO classification, 54.5% were type A, 14.5% were type B and 31.0% were type C and 39.2% of the patient underwent surgery for treatment. The incidence of fracture began to rise in November (12.1%) and peaked in December (14.2%). Conclusion: This study examined the epidemiology and seasonal variance of incidence of distal radius fractures from the patient records of a single University hospital. The epidemiological data gathered in this study could be added to our knowledge of distal radius fractures in the Korean population, thus it enables the Korean surgeon to determine the best management for individual patients.

Treatment of unstable distal radius fractures: non-invasive dynamic external fixator versus volar locking plate - functional and radiological outcome in a prospective case-controlled series.

Introduction: Distal radius fracture (DRF) is a common injury and various treatment modalities including open reduction and internal fixation (ORIF) with volar locking plate are available. More recently, a non-invasive external fixator has been used. Aims: To prospectively compare the use of a non-invasive external fixator with early dynamisation for DRF against ORIF with volar locking plate control group. Methods: Consecutive patients with closed DRF were included in a prospective case-controlled study. Patients were assigned to non-invasive external fixator or ORIF. Minimum follow-up was two years. Follow-up was at weeks 2, 4, 6, 8, 12, 26 and at one and two-year post-operatively. The outcome measures included demographic details, injury mechanism, AO fracture type, risk factors, body mass index (BMI), ulnar styloid fracture and dorsal comminution, radiographs, grip strength and DASH score. Results: Consecutive 50 patients were treated either with non-invasive external fixator (25/50) or with ORIF (25/50) and the mean age of the two groups was 53 years (SD 17.1) and 49 years (SD 19.5), respectively. Demographics were matched in two groups. In the non-invasive external fixator group, there were 10 AO Type-A, 5 Type-B and 10 Type-C fractures. The ORIF group included 8 Type-A, 6 Type-B and 11 Type-C fractures. The mean DASH score at three-months and one-year post-injury in non-invasive fixator group was 12.2 (SD 3.1) and 3.5 (SD 0.7), respectively, significantly greater than those of ORIF group 14.5 (SD 5.6) and 11.2 (SD 4.4), respectively (p < 0.05). Conclusion: DRF treated with non-invasive external fixator can give functional results superior to ORIF at three-months and the trend is maintained at one and two-year post-operatively.

Computed Tomography Arthrography Using a Radial Plane View for the Detection of Triangular Fibrocartilage Complex Foveal Tears

To classify triangular fibrocartilage complex (TFCC) foveal lesions on the basis of computed tomography (CT) arthrography using a radial plane view and to correlate the CT arthrography results with surgical findings. We also tested the interobserver and intra-observer reliability of the radial plane view. A total of 33 patients with a suspected TFCC foveal tear who had undergone wrist CT arthrography and subsequent surgical exploration were enrolled. We classified the configurations of TFCC foveal lesions into 5 types on the basis of CT arthrography with the radial plane view in which the image slices rotate clockwise centered on the ulnar styloid process. Sensitivity, specificity, and positive predictive values were calculated for each type of foveal lesion in CT arthrography to detect foveal tears. We determined interobserver and intra-observer agreements using kappa statistics. We also compared accuracies with the radial plane views with those with the coronal plane views. Among the tear types on CT arthrography, type 3, a roundish defect at the fovea, and type 4, a large defect at the overall ulnar insertion, had high specificity and positive predictive value for the detection of foveal tears. Specificity and positive predictive values were 90% and 89% for type 3 and 100% and 100% for type 4, respectively, whereas sensitivity was 35% for type 3 and 22% for type 4. Interobserver and intra-observer agreement was substantial and almost perfect, respectively. The radial plane view identified foveal lesion of each palmar and dorsal radioulnar ligament separately, but accuracy results with the radial plane views were not statistically different from those with the coronal plane views. Computed tomography arthrography with a radial plane view exhibited enhanced specificity and positive predictive value when a type 3 or 4 lesion was identified in the detection of a TFCC foveal tear compared with historical controls. Diagnostic II.

Ultrasound-guided Hematoma Block for Distal Radial and Ulnar Fractures

BackgroundHematoma blocks of the radius can provide excellent analgesia for simple distal radius fractures. However, the landmark-based approach can be difficult, and ultrasound guidance may improve success of the block and analgesia during reduction. There is limited literature describing the ultrasound-guided approach, and prior case descriptions have not involved comminuted fractures or concomitant ulnar styloid fractures. ObjectivesThis report reviews the technique of the ultrasound-guided hematoma block for distal radius fractures and introduces a second step, which can be used in the case of concomitant distal ulna fractures. DiscussionThe use of the ultrasound-guided hematoma block allows for direct visualization of needle advancement, as well as a simple approach to anesthetizing most distal radial and ulnar fractures. ConclusionThe ultrasound-guided hematoma block may be helpful in improving anesthesia of complicated distal radial and ulnar fractures, especially when landmark-based localization is difficult.

La prise en charge des lésions du TFCC chez les adolescents par arthroscopie et mini voie d’abord

Purpose Post-traumatic injury of the triangular fibrocartilagineus complex (TFCC) can result in debilitating wrist problems. Although diagnosis and treatment of these lesions is well described for the adult population, hardly any data exists for this type of injury in young adolescents. Methods Between 2011 and 2014 seven patients between 10 and 14 years of age have consulted our department for posttraumatic ulnar-sided wrist pain. Previous trauma included distal radial fractures with a concomitant fracture of the ulnar styloid, multiple micro-traumas of the wrist and an overuse injury. Clinical evaluation showed tenderness over the TFCC complex, pain on movement and in most cases instability of the distal radio-ulnar joint (DRUJ) with episodes of sub/dislocation in two patients. Pre-operative arthro-MRIs were conducted confirming the pathology in only 3 cases. Therefore, all patients underwent diagnostic arthroscopy of the wrist followed by surgical treatment according to the discovered lesion. The mean age at the time of surgery was 12.9 years. Results Arthroscopy of the wrist confirmed a TFCC lesion in all patients. In 5 cases the injury was classified as Palmer type 1B, once as a combined type 1A/1B and once as type 1A. All 6 patients with a type 1B injury underwent arthroscopically assisted mini-open reconstruction of the TFCC. Treatment of the type 1A injury consisted of arthroscopic shaving of the central lesion. Postoperative clinical examination revealed stable wrists with a normal range of motion in all cases. Patients reported a decrease in pain-level during daily activities or were entirely pain-free. Conclusion TFCC lesions in the adolescent population are difficult to evaluate on an arthro-MRI and results are often inconclusive. Diagnostic arthroscopy is thus the preferred method of diagnosis for this type of injury. The arthroscopic assisted mini-open TFCC reconstruction is a reliable technique to achieve DRUJ stability and good clinical outcomes.

Determination of the median nerve safe-zone in the carpal tunnel using the distal forearm bony prominences.

The compression of the median nerve (MN) in the carpal tunnel (CT) is one of the most common aetiologies of entrapment neuropathy syndromes in clinical practice. The aim of this study was to investigate the relationship of the palpable bony prominences of the distal forearm (radial styloid process [RSP] and ulnar styloid process [USP]) with MN in the CT, in order to determine a safe-zone of the MN during carpal tunnel procedures. This study involved the bilateral dissection of the CT region of 30 adult cadaveric specimens (n = 60). The mean distance between the RSP and USP was 49.34 mm. The mean distance of the MN from the RSP and the USP were 22.44 mm and 26.66 mm, respectively. The mean diameter of the MN within the CT deep to the flexor retinaculum was 5.93 mm. In addition, the MN was located postero-lateral and postero-medial to palmaris longus tendon (PLT) in 78.33% and 21.67% of specimens, respectively. This study found that the MN was located less than 60% of the RSP-USP distance from the RSP. Furthermore, the MN was mostly located postero-lateral to the PLT. Therefore, injection or surgical incision made at/medial to a point 60% of the RSP-USP distance from the RSP will be outside the safe-zone of the MN. The knowledge of this surface anatomical relationship of the MN may be useful during decompression for CT syndrome.

Effects of Different Taping Pressures of Wrist Taping Using Rigid Tape on Grip Strength Exertion

In general, wrist taping is performed using a rigid tape. The present study aimed to examine the effect on grip strength exertion due to different taping pressures on the wrist joint using rigid tape. Subjects were 25 male university students (mean age, 20.2 ± 0.8 years) with over 5 years of athletic experience. The wrists of the subjects were taped using one piece of rigid tape wound three times around the wrist joint, including the radial and ulnar styloid processes. Furthermore, taping pressure was adjusted by the pressure measuring system AMI3037-SB, and the sensor was set on the palmaris longus muscle tendon of the dominant wrist. Independent variables included four taping pressure conditions (5, 30, 60, and 90 hPa) and a control (no tape) condition. Statistical analysis showed that grip strength exertion was significantly lower in the 90 hPa condition than in the control condition, but the difference was small (effect size = 0.26). In conclusion, wrist taping pressure conditions lower than 60 hPa had little effect on grip strength exertion. However, pressure conditions of 90 hPa slightly decreased grip strength and may interrupt blood flow.

Influence of surgeon, patient and radiographic factors on distal radius fracture treatment.

The purpose of this study was to evaluate surgeon, patient, and radiographic factors influencing the recommendation for operative treatment in distal radius fractures. In a web-based study 252 orthopaedic surgeons from a variety of countries reviewed 30 consecutive sets of radiographs of patients that presented to our emergency department with a fracture of the distal radius. Surgeons were randomly assigned to receive either 'Radiographs only' or 'Radiographs and clinical information'. Surgery was recommended on average 52% of the time whether or not surgeons received clinical information. Female surgeons, surgeons with less than 21 years of experience, and hand surgeons were more likely to recommend operative treatment, but these factors explained only 1% of the variation. Radiographic criteria (intra-articular fractures, ulnar styloid fractures, dorsal comminution, dorsal tilt, and ulnar variance) explained 49% of the variation. The overall agreement on treatment was moderate and slightly higher among surgeons that received radiographs alone. Level of evidence: Level II, therapeutic; not a clinical study.

Restoration of the volar cortex: Predicting instability after manipulation of distal radial fractures

IntroductionDistal radial fractures are one of the most common fractures that are presented to the emergency department (ED). The management of non-emergent cases often involves closed reduction and immobilisation before referral to orthopaedic services. Surgical intervention is offered based on the criteria for instability. This can be predicted from the initial and post-manipulation radiographs. The purpose of this study was to assess the role of various predictors of instability in the requirement for surgery, based on specific evidence-based criteria. Patients and methodWe audited 87 consecutive distal radial fractures that had been manipulated by the ED and analysed what factors predicted instability. ResultsThe most significant predictor of instability and hence further surgery was the failure to anatomically restore the volar cortex (VC) (p=0.002) during the manipulation. Other significant factors were increasing age (p=0.006) and fracture of the ulna styloid (p=0.028). If the VC was restored or remained intact during the manipulation, only 38% required further surgery. If the VC was displaced or not restored, 65% required further surgery. ConclusionThe restoration or maintenance of volar cortical alignment during the manipulation of distal radial fractures offers patients the best chance of avoiding the need for further surgery. This factor should be taken into account in the decision-making process for these fractures.

THE THORACIC LIMB OF THE SURICATE (SURICATA SURICATTA): OSTEOLOGY, RADIOLOGIC ANATOMY, AND FUNCTIONAL MORPHOLOGIC CHANGES

The purpose of the study was to identify unique features of the normal osteology and radiologic anatomy of the thoracic limb of the meerkat or suricate (Suricata suricatta), as no comprehensive information has been published. Bone specimens of 19 suricates were studied. Individual bones of the manus of one preserved carcass were studied in situ. Radiographic evaluation was performed in six animals. Comparisons to domestic carnivores were made and functional morphologic changes were identified. A suprahamate process was present on the scapula spine. Both supratrochlear and supracondylar foramina were present in the distal humerus, with a small Fossa coronoidea seen cranially. The medial epicondyle was markedly larger than the lateral epicondyle. The Tuberositas radii was located caudally. The proximal end of the olecranon was prominent medially. The large medial coronoid process had an extensive proximal articulation facet for the humeral trochlea. The ulna styloid process articulated with the ulnar and accessory carpal bones. The manus was similar to that of domestic carnivores; however, Os metacarpalis I was markedly reduced with the absence of the first digit. There were seven carpal bones. Os carpi radiale was the largest, with a large palmaro-medial process and a small sesamoid bone present medially. Ossa metacarpalia II-V and corresponding phalanges were slender, with an elongated Processus unguicularis (third phalanx) present. Radiologic findings demonstrated increased mobility of the scapula and shoulder joint, with ease of abduction. On the cranio-caudal view of the humerus and elbow joint, the distal radius and manus were consistently rotated in a supinated position. Morphologic changes were identified for the enhanced, predominant function of the shoulder, elbow, carpal, and digital flexor muscles associated with superior digging ability, and supination of the antebrachium and manus. Reference values for size parameters of the long bones are reported. The findings will assist in clinical zoologic medicine and paleozoologic studies.

The outcome of conservative treatment of adult distal radius fractures compared with the other wrist: radiological and functional evaluation

Objective: This study was designed to evaluate anatomical and functional results of closed reduction-long arm cast treatment for distal radius fractures and compared other healthy wrist in the adults. Methods: 77 patients with distal radius fracture were treated conservatively between January 2010 and December 2010. The fractures were classified according to AO and Frykman classification system and investigated prospectively. The radiological and anatomical results were assessed by the Stewart score criteria. The functional results were assessed by Quick-Disability of Arm, Shoulder and Hand questionnaire (Q-DASH) and the Stewart II score criteria. The mean follow-up of patients was 12 months. Results: The forty patients had right wrist fractured, 37 patients had left wrist fractured. According to Frykman classification 46 patients were type I-II fractured, according to AO classification 59 patients were type 23,A2,1 and 23,A2,2 fractured. According to Stewart the radiological and anatomical, the result were excellent in 57, good in 17, fair in 3. According to Stewart II functional criteria, the results were assessed excellent in 57, good in 8, fair in 12 The mean Q-DASH score was 6,37. The overall complication rate was 12.98%. Mild Carpal tunnel syndrome was observed in the two patients, ulna styloid nonunion in the four patients, pain of distal radioulnar joint in the one patient, mild carpal tunnel syndrome and tenderness of distal radioulnar joint in the three patients. Conclusion: Closed reduction and cast immobilization is still an effective and inexpensive treatment method in distal radial fractures. J Clin Exp Invest 2014; 5 (3): 403-409