Can radiographic findings predict outcome of Intra-Articular Distal Radius Fractures? A Prospective Multi-Center Study

Abstract

Our study is to investigate the correlation between the residual deformity and articular incongruity with the functional outcome as well as the grading of osteoarthritis. METHODS: Patients under sixty years with AO type C fractures fixed by plate fixation or external fixation and pinning were recruited. Acceptable reduction was defined as dorsal tilt <10°, radial tilt <20°, ar ticular step or gap <2mm, radial inclination >=10° and radial shortening <5mm. Radiological parameters including deformity and articular incongruity were evaluated by two surgeons. Anatomical parameters included radial height, radial shortening, radial tilt, radial shift, palmar tilt and dorsal/palmar shift. Articular deformity parameters included articular gap, articular step and central depression. Functional outcome was assessed by Green & O'Brien score and Gartland & Werley System. Arthritis was graded with a modification of Knirk and Jupiter criteria. Spearman rank correlations were calculated between the radiological measurements with the functional scores and grading of arthritis. RESULTS: A total of 139 distal radius fractures with a follow-up of 1-2 years were assessed. Radial height, radial shortening, radial tilt and palmar tilt were related to poor function. However, no significant correlation with arthritis could be found with the numbers studied. Articular step or gap and central depression were both related to poor function and arthritis. CONCLUSION: Anatomical results can predict function and articular deformity can predict both function and arthritis in intra-articular distal radius fractures.