[Problems of malunited fractures of the distal radius]

The essential problematic of the distal fracture of the radius lies in the quality of its reduction and retention. 35 patients with distal fractures of the radius and strain fractures of the styloid process of the ulna were followed up with regard to their functional and radiological results and their subjective symptoms. Patients with intra-articular fractures were found to have significantly poorer functional results compared to those with extra-articular fractures. 29 out of 35 patients developed a nonunion of the styloid process of the ulna in the form of a compensatory false position with a significant dorsal tilt of the articular surface of the radius. Their functional results were also significantly poorer than those of the other 6 patients. The patients whose radii were shortened by more than 2 mm also had significantly poorer functional results and a median dorsal tilt of 5 degrees of the articular surface. Where the dorsal inclination of the articular surface of the radius exceeded 5 degrees, a significant increase in the scapholunar angle, which averaged 62 degrees, was found. On the basis of these figures, we conclude that in the reduction of the distal fracture of the radius, shortening by not more than 2 mm and a dorsal inclination of the articular surface of the radius, taken laterally, of not more than 5 degrees should be tolerated in order to minimise functional impairments of the wrist.