Factors influencing the prognosis of radius distal fractures

Radius distal fractures are the fractures of the distal metaphysis of the radius which is the most common fracture in adults. These fractures can be treated either with surgery or conservative methods. The purpose of this study is to examine the relations between clinical outcomes and radiological parameters of the fractures in the treatment of radius distal fractures. 72 patients (40 male, 32 female) who were over the age of 18 and treated surgically or conservatively due to radius distal end fractures between January 2015 and June 2015 in Erzincan Binali Yildirim University, Mengücek Gazi Hospital, Orthopedics and Traumatology Clinic were included in the study. The average age was 49 (18-71, SD:15) Radial inclination, dorsal angulation, volar tilt, and radial length measurements were made on the initial and the final x-rays. The final x-rays of the patients were evaluated according to Knirk & Jupiter arthrosis classification. DASH, Gartland-Werley, and Mayo Wrist Scores were evaluated in their final examinations. The grip strength of both hands was measured with a hand dynamometer. DASH and Gartland-Werley Scores were statistically in favor of the conservative treatment; a negative, moderate to strong relation was detected between the radial inclination and Gartland-Werley Score. A moderate correlation was detected between the initial dorsal angulation and Gartland-Werley, DASH, Mayo Wrist Scores. There was a moderate correlation between the post-reduction volar tilt and Gartland Werley, DASH, Mayo Wrist scores (p<0.01). In our study, the factors that were effective on good clinical outcomes were found to be the restoration of the dorsal angulation and radial inclination before the reduction, and the restoration of volar tilt and radial inclusion in the last roentgenogram in addition to the selection of conservative treatment.