The relationship between initial closed reduction and the surgical reconstruction of the radiocarpal joint line in distal radial fractures

• Published in: Injury Vol. 47; no. 4; pp. 925 - 929
• Main Authors: Lechler, P, Börsch, M, Timmesfeld, N, Schwarting, T, Boese, C.K, Frink, M
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01.04.2016
• Subjects: Biomechanical Phenomena; Bone Plates; Closed reduction; Distal radial fracture; Female; Fracture Fixation, Internal - methods; Fracture Healing; Germany; Hospitals, Teaching; Humans; Internal fixation; Male; Middle Aged; Orthopedics; Palmar tilt; Radial inclination; Radiocarpal joint; Radiography; Radius Fractures - diagnostic imaging; Radius Fractures - physiopathology; Radius Fractures - surgery; Range of Motion, Articular; Recovery of Function; Retrospective Studies; Treatment Outcome; Wrist Joint - diagnostic imaging; Wrist Joint - physiopathology; Closed reduction; Internal fixation; Radial inclination; Palmar tilt; Distal radial fracture; Radiocarpal joint
• ISSN: 0020-1383; 1879-0267
• DOI: 10.1016/j.injury.2015.11.031

Abstract Introduction Whilst initial closed reduction followed by definitive open fixation is widely applied in the treatment of distal radial fractures, the effect of the closed reduction on the reconstruction of the articular surface remains unclear. Our research questions were: (1) Does closed reduction followed by surgical fixation reconstruct palmar tilt and radial inclination? (2) Does closed reduction influence the surgically reconstructed palmar tilt and radial inclination? Methods Palmar tilt and radiocarpal inclination of 425 patients were measured at admission, following initial closed reduction and after surgical reconstruction. Results Closed reduction increased palmar tilt by 12.1° and radial inclination by 2.7°. Open surgical reduction further corrected palmar tilt by 17.88° and radial inclination by 3.5°. Whilst there was no association between postoperative palmar tilt and initially achieved closed reduction, a significant association between radial inclination following closed reduction and surgical fixation was found. Conclusion Our retrospective study challenges the existence of a relationship between the initial closed reduction and the reconstruction of the anatomic joint line in surgically treated distal radial fractures.