Complex Fractures of the Distal Radius

Abstract

Objective:

Outcome of complex distal radius fractures. Design: Retrospective clinical observation.

Setting:

Outcome assessment of a clinical series of patients with complex distal radius fractures treated according to a structured, stepwise treatment algorithm.

Patients:

17 patients (average age 47 years) with mostly high-energy injuries, 16/17 articular fractures including concomitant carpal injuries, fracture dislocations, extension of the fracture into the diaphysis, and large defects.

Intervention:

Initial external fixation, followed by soft tissue treatment and further diagnostics and, finally, definitive adapted surgical therapy including combination of external fixation, plates, screws, K-wires, bone graft, and ligament repair.

Main Outcome Measurements:

DASH, range of motion, radiologic outcome.

Results:

Average subjective overall performance score (DASH) 16.4 (0–36.7, standard deviation [SD] 11.82, 95% confidence interval [CI] 8.0–23.6), 73% of the patients back to premorbid work and activities.

Conclusions:

Using a clearly structured, stepwise approach, complex distal radius fractures can be treated with good clinical outcome preserving hand function.