Radiographic Changes in Conservatively Treated Distal Radius Fractures

ABSTRACT

PURPOSE: To evaluate the radiographic changes in distal radius fractures treated conservatively. MATERIALS AND METHODS: We reviewed 55 patients with a distal radius fracture treated by conservative treatment. Average age was 57.6 years. According to the AO classification, 17 were A2 fractures followed by C1 (13 cases), C2 (9 cases), C3 (7 cases), B1 (6 cases) and A3 (3 cases). Closed reduction and U-shaped splint were applied as initial treatment. Long arm cast followed by short arm cast were applied for intraarticular or metaphyseal comminuted fractures. Radial inclination angle, radial length and volar tilt angle in each radiograph were measured and evaluated by statistic analysis. Radiographic changes according to ages, comminution of metaphysis and fracture type were also evaluated. RESULTS: Radial inclination, radial length and volar tilt were 22.8degrees, 12.0 mm and 8.5degrees after closed reduction, 22.1degrees, 10.5 mm and 7.7degrees at casting, 20.1degrees, 8.7 mm and 4.5degrees at cast off, and 18.7degrees, 7.4 mm and 4.1degrees at last follow-up. All three values had statistical significances between casting and removal of cast (p<0.001, p<0.001, p=0.002). Radial inclination angle and radial length in the group over 60 years had statistical significances between casting and removal of cast, comparing with the group under 60 years (p=0.037, p=0.045). CONCLUSION: Loss of reduction was more prominent between 3 to 6 weeks after injury, especially in the group 60 years or older.