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Displaced Intra-Articular Fractures of the Distal Aspect of the Radius. Long-Term Results in Young Adults after Open Reduction and Internal Fixation

Displaced Intra-Articular Fractures of the Distal Aspect of the Radius. Long-Term Results in... The purpose of this retrospective study was to determine the long-term functional and radiographic outcomes in a series of young adults (less than forty-five years old) in whom an acute displaced intra-articular fracture of the distal aspect of the radius had been treated with operative reduction and stabilization. Twenty-six fractures in twenty-six patients met the initial inclusion criteria for the study. Twenty-one patients returned for a physical examination, imaging (plain radiographs and computerized tomography scans), and completion of a validated musculoskeletal function assessment questionnaire at a minimum of 5.5 years. The physical examinations were performed by the same observer, who was not involved in the initial care of the patients. The plain radiographs and computerized tomography scans were assessed in a blinded fashion by two independent observers who measured the radiographic parameters with standardized methods. At an average of 7.1 years, osteoarthrosis of the radiocarpal joint was evident on the plain radiographs and computerized tomography scans of sixteen (76 per cent) of the twenty-one wrists. A strong association was found between the development of osteoarthrosis of the radiocarpal joint and residual displacement of articular fragments at the time of osseous union (p < 0.01). However, the functional status at the time of the most recent follow-up, as determined by physical examination and on the basis of the responses on the questionnaire, did not correlate with the magnitude of the residual step and gap displacement at the time of fracture-healing. All patients had a good or excellent functional outcome irrespective of radiographic evidence of osteoarthrosis of the radiocarpal or the distal radio-ulnar joint or non-union of the ulnar styloid process. It appears prudent therefore to base the indications for salvage operative procedures on the presence of severe symptoms or a loss of function rather than on radiographic evidence of osteoarthrosis of the radiocarpal joint. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Journal of Bone and Joint Surgery Wolters Kluwer Health

Displaced Intra-Articular Fractures of the Distal Aspect of the Radius. Long-Term Results in Young Adults after Open Reduction and Internal Fixation

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Publisher
Wolters Kluwer Health
Copyright
Copyright © 1997 by The Journal of Bone and Joint Surgery, Inc.
ISSN
0021-9355
Publisher site
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Abstract

The purpose of this retrospective study was to determine the long-term functional and radiographic outcomes in a series of young adults (less than forty-five years old) in whom an acute displaced intra-articular fracture of the distal aspect of the radius had been treated with operative reduction and stabilization. Twenty-six fractures in twenty-six patients met the initial inclusion criteria for the study. Twenty-one patients returned for a physical examination, imaging (plain radiographs and computerized tomography scans), and completion of a validated musculoskeletal function assessment questionnaire at a minimum of 5.5 years. The physical examinations were performed by the same observer, who was not involved in the initial care of the patients. The plain radiographs and computerized tomography scans were assessed in a blinded fashion by two independent observers who measured the radiographic parameters with standardized methods. At an average of 7.1 years, osteoarthrosis of the radiocarpal joint was evident on the plain radiographs and computerized tomography scans of sixteen (76 per cent) of the twenty-one wrists. A strong association was found between the development of osteoarthrosis of the radiocarpal joint and residual displacement of articular fragments at the time of osseous union (p < 0.01). However, the functional status at the time of the most recent follow-up, as determined by physical examination and on the basis of the responses on the questionnaire, did not correlate with the magnitude of the residual step and gap displacement at the time of fracture-healing. All patients had a good or excellent functional outcome irrespective of radiographic evidence of osteoarthrosis of the radiocarpal or the distal radio-ulnar joint or non-union of the ulnar styloid process. It appears prudent therefore to base the indications for salvage operative procedures on the presence of severe symptoms or a loss of function rather than on radiographic evidence of osteoarthrosis of the radiocarpal joint.

Journal

Journal of Bone and Joint SurgeryWolters Kluwer Health

Published: Sep 1, 1997

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