The Results of Management of Distal End Radius Fractures by Various Modalities

Abstract

Background: Distal end radius fractures constitute 16%-20% of all fractures. Extra-articular fractures are managed with closed reduction and casting, while intraarticular fractures require more invasive treatment due to instability and conservative treatment complications. Despite extensive research, the optimal treatment for distal end radius fractures remains unclear, prompting ongoing comparative studies.
Methods: 40 patients were treated and followed up for 3 to 14 months. Each patient underwent detailed clinical and radiological examinations of the affected wrist using the Arbeitsgemeinschaft für Osteosynthesefragen (AO) classification. Radiographs were routinely taken to evaluate extra-articular deformities and articular incongruences. Treatment decisions ‒plating, external fixation, or conservative management ‒were based on fracture type and patient physiology. Follow-ups occurred at various intervals, with assessments including hand grip strength comparison, radiographic measurements, and clinical evaluation of fracture union using Green and O’Brien scoring and Sarmiento radiological criteria.
Results: 40 patients with distal end radius fractures, averaging 40.62 years old, were included in the study. Treatment distribution was eight patients with reduction cast/slab, 18 with external fixators, and 14 with plating. Plating showed 57.28% excellent, 28.57% good, and 14.28% fair outcomes. External fixators had 33.33% excellent, 33.33% good, 16.67% fair, and 16.67% poor outcomes. Conservative management had 25% excellent, 37.5% good, 25% fair, and 12.5% poor outcomes.
Conclusion: Conservative management with a reduction pop slab/cast is suitable for extra-articular fractures in elderlies. External fixation is effective for osteoporotic or comminuted fractures. Plating is recommended for intra-articular fractures in young patients.