Effect on wrist joint stability following distal radial fractures / 中华外科杂志

ABSTRACT

<p><b>OBJECTIVES</b>To investigate the influence of wrist joint stability of patients with diversified fracture of the distal radius, and to find out the difference of the clinical effect between the patients with surgical treatment and non-surgical treatment.</p><p><b>METHODS</b>From January 1999 to September 2006 a total of 200 cases with the fracture of the distal radius were reviewed according to the AO classification, the radiolunate angle, scapholunate angle, palmar tilt angle and the length of the radial shorting and step-off of the articular surface were measured by the standard X-ray. Gartland and Werley as modified by Sarmiento evaluation system was used, and the results were statistically analyzed.</p><p><b>RESULTS</b>The average follow-up period was 5 years and 2 months. The follow-ups revealed 5 types of carpal instability scapholunate dissociation, volar intercalated segment instability, dorsal intercalated segment instability and palmar or dorsal shift of the carpus. Functional results were excellent and good in 78% of the total patients. The increasing of the length of the radial shorting and step-off of the articular surface was found to be associated with greater risk of carpal instability.</p><p><b>CONCLUSIONS</b>Based on the results of the study, wrist articular surface and radial shortening and palmar tilt angle should be considered as the most important factors of the healing effect after the fracture of the distal radius. Wrist joint stability depends on the structure of the bone and ligament around wrist joint. Carpal instability wound leads to significantly effect on the wrist. And surgery was necessary to severe intra-articular fracture of the distal radius.</p>