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Erschienen in:
01.03.2016 | Handsurgery
1-Year outcome of concomitant intracarpal lesions in patients with dislocated distal radial fractures: a systematic assessment of 78 distal radial fractures
Erschienen in: Archives of Orthopaedic and Trauma Surgery | Ausgabe 3/2016
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Introduction
Ligamentous lesions are concomitant to dislocated distal radius fractures in a high percentage. The purpose of this study was to evaluate the relevance of intracarpal lesions.
Methods
Seventy eight of an original cohort of 104 distal radius fractures (74 %) were studied over a follow-up period of one year after surgery with complete data (X-rays, CT, MRI, follow-up X-rays and questionnaire).
Results
Most of our radius fractures (AO 23 type: A 39, B 9, C 30) present additional lesions: 97 %. One-year evaluation showed an average Castaing score of 4.5 ± 2.5 points, means a “good” result of a scale of 0–27. Fifty five of seventy eight had an “excellent” or “good” result (<6 points). No patient had more than 12 points (“fair”).
Conclusions
The dislocated distal radial fracture implies severe and complex injury to the whole wrist, mostly concerning intracarpal concomitant lesions (MRI). Surgical therapy of dislocated radius fractures followed by 6 weeks relief through thermoplastic splint seems to be sufficient to achieve good 1-year results. MRI-detectable carpal lesions at the time of the radial fracture are common, but only a few of them seem to decompensate later, give symptoms and became of therapeutic relevance.