Conservative treatment of distal radius fractures, importance of radial height

Abstract

Decision of conservative treatment or surgery still remains a debate for some particular types of radius distal fractures. We aimed to evaluate the clinical and radiological results of a patient group treated in our clinic with closed reduction and plaster cast fixation and tried to evaluate the prime fac-tors affecting stability and prognosis of conservative treatment. The study comprised 51 patients (34 males, 17 females; mean age 39.8 ± 11.3 years) treated with closed reduction and plaster cast fixation for radius distal end fracture at our clinic during the period January 2007 to September 2010. Ob-tained clinical results were scored according to the Gartland and Werley clini-cal evaluation system12 and the Disability Arm, Shoulder and Hand Surgery Questionnaire (DASH), for radiological examination; arthritic changes were evaluated according to the Knirk and Jupiter arthritis scoring system and an-gulation evaluation was made according to the Stewart’s radiological evalu-ation criteria. Mean follow-up period time was 17.1 months (range, 6-48 months). According to the Gartland and Werley clinical evaluation system 23 patients had (45.1%) 0-2 points (excellent), 19 (37.3%) had 3-8 points (good) and 9 (17.6%) had 9-20 points (moderate). No poor results were determined. Loss of radial height had a negative effect on functional outcome, radial height is one of the prime factors affecting the prognosis of the treatment. Impairment of the radial inclination, radial shortening or loss of palmar incli-nation were not observed to negatively affect the prognosis.