ABSTRACT
BACKGROUND AND AIMS: Whether or not radiological results correlate with functional outcome after operative treatment of distal radius fractures still remains controversial. We carried out a retrospective study to analyse the long-term (6.5 year) outcome of radius fractures treated by means of surgery in our hospital. The aim of the study was to explore whether step-off on radius joint surface, shortening of the radius versus ulnar height and dorsal or volar tilt of the radius correlate with long-term Patient-Rated Wrist Evaluation or Quick Disability of the Arm, Shoulder and Hand scores among 100 consecutive patients after surgical treatment. MATERIALS AND METHODS: Of these, 60 patients (63 wrists) participated. They were examined radiologically, clinically and by means of a questionnaire. RESULTS: Shortening of the radius correlated significantly with both Patient-Rated Wrist Evaluation and Quick Disability of the Arm, Shoulder and Hand scores. Step-off on the radius joint surface correlated significantly with worse PRWE scores, with no difference in Quick Disability of the Arm, Shoulder and Hand evaluation. Dorsal or volar tilt showed no statistical correlation (though it was mild in this group). The age of the patients (below 60 years vs 60 years or above) did not affect the PRWE or Quick Disability of the Arm, Shoulder and Hand results. CONCLUSION: Our results indicate that when it comes to conserving the radial height and congruence of the joint surface, the more precise the reduction of the fracture achieved by surgical means, the better the functional outcome.
ABSTRACT
BACKGROUND AND AIMS: This investigation was made to elucidate the outcome of conservatively treated scaphoid fractures. MATERIAL AND METHODS: 63 patients with a scaphoid fracture were treated initially conservatively and examined retrospectively. The mean follow up time was 54 months. RESULTS: In this group bone union was achieved in 56 cases (89%). Three of the patients ended up to operation because of delayed union soon after conservative treatment and three nonunions were found in the follow up appointment. One fracture did not heal because of dislocation during cast treatment and was treated with operation. Incidence of osteoarthrosis and residual symptoms were studied in the group with totally conservative treatment. Osteoarthrosis was found in 19 (32%) wrists, but no correlation with wrist problems (pain, reduced grip strength or problems at work) was found. 20 (34%) of the patients complained residual symptoms. Most of the symptoms were mild and did not impair their ability to work or cause serious problems during free time. CONCLUSION: According to the present study conservative treatment is a safe method for the treatment of undislocated stabile scaphoid fractures.
