Background
Fractures of the distal radius are common, especially in elderly patients. Treatment consists of closed reduction and immobilization. Long-term effects of malunion indicate surgery for potentially unstable fractures.
Patients and methods
A prospective study was conducted in 60 patients with a distal radius fracture between February 2012 and January 2013 and matched with criteria included in this study. The strategy of management was subdivided into plaster cast immobilization with subsequent rehabilitation, manipulation with subsequent cast immobilization, and surgery (volar plating). Outcomes were graded as good or poor based on the complications and the function achieved at the end of follow-up.
Results
A total of 60 patients were included in the study. Thirty five patients had less than or equal to 3 instability markers (group A) and 25 had more than or equal to 4 (group B). Overall, 42 were female and 18 were male. The average age was 58 years, with an age range of 20–65 years, in group A, whereas the average age was 57 years, with an age range of 21–63 years, in group B.
Conclusion
Presence of four or more instability markers is globally associated with a poorer outcome. Patients with four or more markers who underwent surgery did uniformly better than those with manipulation alone. In patients with three or fewer markers, nonoperative management achieved good outcomes.