Seven-Year Outcome Following Colles’ Type Distal Radial Fracture. A Comparison of Two Treatment Methods

Abstract

Eighty-five patients were reviewed 7 years after prospective randomization to bridging external fixation or plaster immobilization for treatment of a Colles' type distal radial fracture. The Gartland and Werley score showed that most patients in each group had an excellent or good outcome and patient satisfaction was comparable and high in both groups. The fixator group had significantly less radial shortening (P<0.05). Despite a high level of radiographic malunion (50%) overall function, range of movement and activities of daily living were not limited. Twenty-five per cent of patients had minor radiological signs of post-traumatic arthritis although only one patient was symptomatic. We conclude that, in the long term, external fixation of distal radius fractures does not confer an improved outcome when compared to plaster immobilization.

Can radiological results be surrogate markers of functional outcome in distal radial extra-articular fractures?

“…However, Cassebaum concluded that good function ensued, despite poor anatomical results [2]. Some authors have shown that there is no correlation between functional outcome and satisfactory radiological results [23,24].…”

Influence of associated lesions of the intrinsic ligaments on distal radius fractures outcome

“…Clinical studies that have evaluated outcomes of distal radius fractures from the perspectives of patient satisfaction, perception of disability, and quality of life after the injury did not find associations with radiographic outcome, suggesting that a well-treated bone lesion does not guarantee patient satisfaction [1,7,13,16,33]. This finding may be explained by the presence of associated soft-tissue lesions that were not recognized or treated.…”

Dorsally angulated fractures of the distal radius

“…Patients were randomised to bridging external fixation or plaster immobilisation. The conservatively managed group demonstrated worse radiographic findings, with wrist arthritis and radial shortening but no difference in upper limb function was demonstrated (Young et al, 2003). These studies highlight the lack of consensus as to what degree of radiographic malunion is considered to be acceptable.…”