Treatment Results in Radius Distal Tip Fractures

Abstract

Purpose: To discuss the results obtained from the cases applied various treatment methods according to the fracture type in our clinics.
Patients and methods: 62 of totally 100 cases of various types according to AO classification were applied immobilization by means of closed reduction and cast (36 classical, 26 neutral position), and 38 of them were treated surgically. The mean follow up period was 22.37 months. Volar tilt, radial angulation and radial length measures obtained postoperatively and at the last controls from the radiograms were compared among themselves and with the normal wrist. Clinically, wrist motion range was measured and the power of pinch and grasp was measured by means of a hand dynamoeter and they were compared with the normal wrist. The data obtained were evaluated clinically according to the Gardland - Werley and radiologically according to the Stewart criteria. Comparisons were made statistically by means of student t test and variance analysis.
Results: Radiologically, in classical position castings 94.44%, in neutral position castings 88.47%, in surgical treatment 89.47%; and clinically, in classical position castings 72.22%, in neutral castings 96.15%, and in surgical treatment 84.21% perfect and good results were achieved.
Discussion: With the determination of stability and instability concepts in radius distal tip fractures, in addition to conservative treatment, surgical treatments also gain importance. It is indicated that the most important factor in achieving good results is the restoration of radial length, and the most important factor in getting bad results is the residual dorsal angulation.
Conclusion: The treatment method in radius distal tip fractures should be chosen according to the type of fracture. It was observed that the dorsal angulation was the most difficult to correct, and that the radial angulation and radial shortness were the easiest to correct. Also it was seen that the volar tilt values obtained especially in classical position couldn't be preserved in conservative treatment.