Radiological Parameters and Functional Outcomes in Distal Radius Fractures: A Narrative Review

Abstract

Distal radius fractures continue to stay at the top among older adults where fragility from osteoporosis and increased fall risk make them particularly vulnerable. Yet, despite the frequency with which these injuries are treated, clarity is still lacking around the relationship between radiological alignment parameters after reduction and functional outcome. For patients who depend on their wrists for work, independence, or daily routines, this uncertainty can mean the difference between functional restoration and lingering limitation. This review revisits the evidence that includes four radiological parameters; radial inclination, volar tilt, radial height, and ulnar variance to tangible functional outcomes. By examining literature across PubMed, Scopus, and Google Scholar from January 2000 through March 2024, we aimed to trace patterns connecting alignment with clinical metrics such as grip strength, pain levels, wrist mobility, and validated scoring tools like DASH and PRWE. Optimal outcomes were most favourable when alignment was restored within specific anatomical norms: radial inclination between 21°-25°, volar tilt of 10°-15°, radial height in the range of 9-12 mm, and ulnar variance close to neutral. Deviations from these thresholds often translated into reduced motion, persistent pain, and lower patient-reported function. These findings reinforce the importance of respecting anatomical parameters during treatment planning, promoting precision in alignment to maximise long-term function and patient satisfaction.