Redisplacement of Distal Radius Fracture after Initial Closed Reduction: Analysis of Prognostic Factors

Abstract

BackgroundTo evaluate risk factors of redisplacement and remind surgeons of key factors regarding conservative treatment of distal radius fracture.MethodsA total of 132 patients who received conservative treatment for distal radius fractures between March 2008 and February 2011 were included in this study. Radial inclination, radial length, volar tilting angle, ulnar variance, fragment translation, and presence of dorsal metaphyseal comminution were measured on the X-rays taken immediately after reduction, one week after injury during the first follow-up outpatient clinic visit, and after the gain of radiological union. Secondary displacement was defined as a loss of reduction during the follow-up period, and was divided into 'early' and 'late' categories. We analyzed the influence of initial displacement radiologic variables, dorsal cortex comminution, and patient age on the development of secondary displacement.ResultsDevelopment of secondary displacement was significantly associated only with initial displacement radiologic variables (p < 0.001), development of the late secondary displacement was significantly associated with age (p = 0.005), and initial displacement radiologic variables were associated significantly with a serial increase in ulnar variance (p = 0.003).ConclusionsGreater displacement on the initial radiographs indicates a higher possibility of development for secondary displacement, and older patients had a higher probability of late secondary displacement development. Furthermore, dorsal comminutions did not affect secondary displacement directly.

Treatment of dorsally dislocated distal radius fractures with individualized 3D printed bracing: an exploratory study

“…Two secondary fracture displacements in five patients is comparable with the results of non-operative treatment of DRF in the literature [12]. Prognostic factors for redisplacement after initial closed reduction are greater initial displacement and age [13]. So it is not unexpected to see a high rate of redisplacement in our target group: the older patient with severely dislocated DRF.…”

Conservative Treatment of Distal Radius Fractures: A Prospective Descriptive Study

“…Postreduction radiographs (posteroanterior and lateral views) were used to evaluate the radial tilt, the radial inclination, and the radius length (measured in millimeters), according to predefined published measurements. 16 Radial length was defined as the axial difference between the distal radial and ulnar articular surfaces on a posteroanterior radiograph of the wrist 4,18,27 as shown in Figure 1a. Ten to twelve millimeters is the average radial length.…”

Correlación entre el dolor y los índices radiológicos en pacientes mayores de 60 años con fractura de radio distal

“…Algunos estudios han reportado que la restitución de los parámetros anatómicos normales, basada en índices radiológicos, es un factor pronóstico de buenos resultados funcionales postfractura, reduciendo de esta forma la incidencia de dolor postraumático (5,(8)(9)(10)(11). Los índices radiológicos más frecuentemente reportados en la bibliografía para evaluar la reducción de una FRD de tipo extrarticular son: ángulo de inclinación radial, altura radial, angulación volar, varianza ulnar y escalón articular (4)(5)(6)(7)12,13). La correlación directa de estos índices radiológicos con los resultados funcionales ha sido un argumento frecuentemente usado por los cirujanos ortopédicos para decidir entre un tratamiento quirúrgico o uno conservador (14)(15)(16)(17).…”