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FRACTURES OF THE DISTAL RADIUS TREATED CONSERVATIVELY SHOWED IMPROVEMENT IN FUNCTION BETWEEN 6 MONTHS AND 1 YEAR.



Abstract

Fractures of the distal radius are common skeletal injuries. In most practices patients are discharged within few weeks to few months. The aim of this study is to investigate whether there is a difference in outcome between 6 months and 1 year with different treatment methods with special focus on conservative management.

A one-year prospective cohort study of patients with fractures of the distal radius was set in York Hospital. From 204 patients included, 200 (98%), 182 (89%) and 164 (82%) patients were evaluated at 6 weeks, 6 months and 1 year, respectively. Two patients had bilateral fractures. In total 162 fractures were treated conservatively, and 8 fractures were treated operatively following failure of conservative immobilization.

Outcome assessment included Gartland and Werley, DASH and SF-36 scoring systems. Between 6 months and 1 year there was statistically significant improvement in the over-all Gartland and Werley score (p< 0.001) and most of its components such as the subjective evaluation, grip strength, arthritis change, finger function, and the range of motion. There was no significant improvement in pain and deformity.

In the conservatively treated patients a good or excellent result was found after 6 months in 77%, after 1 year in 92%. In the failed conservative group it was 61% (5/7) and 83 % (5/6).

Conclusion: This study has shown that functional improvement occurs up to 1 year following distal radius fractures, therefore a final say in the outcome may not be determined before that time should the need arise for reconstructive surgery or medico legal advice.

Correspondence should be addressed to Ms Larissa Welti, Scientific Secretary, EFORT Central Office, Technoparkstrasse 1, CH-8005 Zürich, Switzerland