In a prospective study we evaluated the results of 272 distal radial fractures by their involvement of the distal radioulnar joint. Impaired function following altered anatomy at the distal radius can be explained by dysfunction of the distal radioulnar joint. Ulnar styloid avulsions contribute to a poorer result because of their effect on distal radioulnar joint function.

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The long-term results with an average of 4.3 years of 87 patients with an AC-dislocation grade III according to Tossy, treated operatively with a Bosworth screw or a Wolter plate are described and submitted to critical evaluation. Of the patients 16% had implant failures. Redislocation was seen in 25% of the patients, calcifications in 39% and arthritis in 41%. The end-result was good or excellent in 60% of the patients and fair or bad in 40%. The only factor, influencing the end result was the redislocation rate (p < 0.05). These moderate results surprised and disappointed us. They made us conclude that the grade III acromioclavicular dislocation is no absolute indication for surgical treatment, as is often suggested in literature. No significant differences could be revealed between both surgical techniques.