Original articlesDistal radius fracturesAssessment of instability factors in adult distal radius fractures
Section snippets
Materials and methods
From February 2002 to February 2003 there were 289 fractures of the distal radius that were treated consecutively at our institution. Standard initial treatment consisted of local hematoma block, 10 pounds of finger-trap traction, and manual closed reduction of the fracture. Each patient was placed into a well-molded sugar-tong splint. Postreduction radiographs were performed in the posteroanterior, lateral, and oblique planes. Follow-up radiographs were obtained at 1 week, 2 weeks, and 4 weeks
Results
Based on the radiographic measurements and criteria for an acceptable reduction the number of patients who failed to maintain an adequate reduction at 1 week was 17 (34%), at 2 weeks an additional 7 patients failed (48%), and at 4 weeks an additional 3 patients failed (54%) (Fig. 7). Of the total 27 patients who failed at 4 weeks, 10 patients failed because of excessive dorsal tilt, 7 patients failed because of excessive radial shortening, 5 patients failed because of excessive radial
Discussion
Fractures of the distal radius are common, especially in elderly patients. Initial treatment consists of closed reduction and immobilization. With increasing knowledge and understanding of fracture patterns and the long-term effects of malunion, however, a more aggressive surgical approach has been used for potentially unstable fractures. The definition of instability has been a topic of controversy for decades. The results of this study will aid the clinician in identification and treatment
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2022, Orthopaedics and Traumatology: Surgery and ResearchCitation Excerpt :DRFs in older patients have typically been treated conservatively with closed reduction and cast immobilization [3]. However, this method of treatment may fail to maintain reduction, and re-displacement or malunion rates is reported in over 50% of cases [4], as age is one of the most significant risk factors for loss of reduction and secondary fracture displacement [5,6]. When the initial reduction fails to meet acceptable radiographic parameters, surgical management, such as internal or external fixation, may be used [7].
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