Comparison of Treatment Proposed Based on Prediction of the Risk of Instability with Orthopedic Surgeons’ Preferred Treatment for Management of Distal Radius Fracture

Abstract

Background: Calculation of the risk of instability and malunion in patients with distal radius fracture and choosing treatment based on this risk percentage is a new method that can greatly help surgeons in decision-making. In this study, we have tried to make a comparison between treatment decision-making based on prediction of the risk of instability and experience of orthopedic surgeons for management of this fracture.
Methods: Recorded information of 69 patients with extra-articular distal radius fracture diagnosis was examined. Radiographs and age of each patient were submitted to two orthopedic surgery professors and they were asked to express their opinion about surgical or non-surgical treatment for each patient based on their own personal habit. The risk of instability was calculated for each patient and surgical or non-surgical treatment for each patient was proposed based on this risk percentage with cut-off point of 70%. Then, the treatment proposed by each surgeon was compared with the treatment proposed based on the calculated risk of instability.
Results: The study demonstrated that treatment decision-making for distal radius fracture according to the risk of instability with cut-off point of 70% (this is surgery for fractures with instability risk of more than 70% versus non-surgical intervention for cases with risk of less than 70%) is not significantly and reliably consistent with the opinions of two orthopedic surgeons who had the experience of confronting this fracture.
Conclusions: Prediction of the risk of instability for management of distal radius fracture needs to be validated through further studies before being used as the decisive factor for management of this fracture. Colleagues are invited to assess the outcomes of using the risk of instability more accurately with further studies. It is suggested to be more prudent and perform more evaluations when the risk of instability calculation with cut-off point of 70% is used to choose the appropriate treatment.