Article
Early indication for the surgical treatment of the distal radial fractures
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Authors
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Neritan Myderrizi
- Spitali Rajonal Durres, Sherbimi Kirurgji Ortopedise, Durres Albanien, andere
| Published: | September 16, 2010 |
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Outline
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Objective: Although the fractures of distal radius are a common clinical situation for the orthopedist, we did not find any information in the literature that would allow safe decision-making on the best treatment for each fracture type. The aim of the present study was to find an early solution of treatment of this fracture using AO classification
Methods: We have studied functional and anatomic result of fractures of distal radius at 101 patients from 18 to 82 years old (54.29 mean ages) which are treated conservatively with cast immobilisation. We have classified all the fractures under AO classification. All the fractures have been immobilised in below elbow cast for 5-8 weeks. Follow up was 24 months
Results: 64 were female and 37 male, 36 were right hands and 65 left from them 38 were dominant.
All the fractures were reduced in a mean radial tilt 17.5 grade, mean ulnar migration of 0.95 mm and mean volar tilt of -0.85 grade.
Radial tilt: A1 23, A2 17.8, A3 19.1, B1 20.2, B2 20.3, B3 18.2, C1 18.29, C2 19.3, C3 17.5.
Ulnar Migration: A1 1, A2 0.38, A3 1.05, B1 0.4, B2 0.5, B3 0.6, C1 1.0, C2 1.61, C3 1.66.
Volar tilt: A1 11, A2 0.3, A3 -1.9, B1 4.4, B2 -2.1, B3 -0.4, C1 -0.4, C2 -1.7, C3 -4.5.
In Follow up after 2 months it was seen a mean radial tilt of 15.57 grade, mean ulnar migration of 2.72mm and volar tilt of -3.53 .
Radial tilt: A2 16.42, A3 14.47, B1 18.6, B2 18.6, B3 16.4, C1 15.41, C2 14.4, C3 12.5,
Ulnar Migration: A2 2.2, A3 5.6, B1 1.0, B2 1.16, B3 2.2, C1 3.17, C2 5.6, C3 7.0.
Volar tilt: A2 -0.8, A3 -5.7, B1 3.6, B2 6.6, B3 -1.0, C1 -2.17, C2 -5.8, C3 -8.1.
Functional results were excellent in 9 cases (8.8%), good in 15 cases (14.7%), fair in 37 cases (36.2%) and bad in 40 cases (39.2%).
In this study it was seen that ulnar migration (-0.629) and volar tilt (0.664553) have a strong influence in the range of movement of the wrist and the grasp.
Loss of radial tilt has a smooth correlation (0.548) with the loss of function
Conclusion: Giving always priority to the anatomic restoration of distal radius to decrease the loss of function we should consider early surgical treatment for the fractures of the distal radius type A3, B2, B3, C2, C3 .
