Treatment of colle's fracture with wrist immobilization in palmar flexed and dorsiflexed position

ABSTRACT

To evaluate and compare the radiological and functional results of immobilization of Colle's fracture treated conservatively in two different positions of wrist i.e. palmarflexion [PF] and dorsiflexion [DF]. A Descriptive Cross Sectional Study. Sixty patients with closed Colle's fracture who were treated conservatively by close reduction and below elbow cast application were included in this study. The study was conducted at Department of Orthopedics, Railway Hospital, Westridge, Rawalpindi from November 2008 to May 2011. The patients were alternately allocated to dorsal or palmar flexed immobilized position of wrist. Patients were followed up for a minimum six-month period. The radial tilt, palmar tilt and ulnar variance were measured at 6 month follow up. The results were scored by Demerit Scoring System of Saito. All fractures were united. Individual movement of dorsiflexion, palmar flexion, supination, and radial-ulnar deviation [except pronation] were all significantly better in the dorsiflexed-immobilized group as compared with the palmar flexed immobilized group. Grip strength recovery with subjective assessment was better in the dorsiflexed group as compared to the PF group. Radiological parameters were markedly better in the dorsiflexed group. 100% of patients in the dorsiflexed group had overall excellent results as compared to 23.3% in the palmar flexed group in terms of radiological and functional outcome. Functional and radiological results of Colle's fractures are superior if the fractures after reduction are immobilized in dorsiflexion of wrist ratherthan in conventional palmarflexion position