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Open reduction and internal fixation for distal radius fractures.
M L Missakian1, W P Cooney, P C Amadio
1Department of Orthopedics, Mayo Clinic, Rochester, MN 55905.
The Journal of Hand Surgery
|July 1, 1992
Summary
Open reduction and internal fixation effectively treat complex distal radius fractures. Most patients achieved satisfactory functional and radiographic outcomes, though significant displacement impacted results.
Area of Science:
- Orthopedic Surgery
- Traumatology
- Radiology
Background:
- Distal radius fractures are common, with intra-articular involvement presenting treatment challenges.
- Frykman and Mayo classifications aid in categorizing these complex fractures.
- Open reduction and internal fixation (ORIF) is a primary surgical approach.
Purpose of the Study:
- To evaluate the outcomes of ORIF for intra-articular distal radius fractures.
- To correlate fracture characteristics with functional and radiographic results.
- To identify factors predictive of post-traumatic arthritis.
Main Methods:
- Retrospective analysis of 32 intra-articular distal radius fractures treated with ORIF.
- Fracture classification using Frykman (types VII, VIII) and Mayo (types II, III, IV) criteria.
- Functional assessment (Gartland and Werley) and radiographic evaluation (Lidström) at minimum 2-year follow-up.
Main Results:
- 90% satisfactory subjective results (minimal deformity, pain, good strength).
- Objective outcomes: 80% normal motion, 73% normal grip strength.
- 87% good to excellent radiographic and functional outcomes.
- Intra-articular step-off >2mm or radial shortening >5mm correlated with fair results and arthritis.
Conclusions:
- ORIF provides good to excellent outcomes for intra-articular distal radius fractures.
- Accurate reduction is crucial; significant step-off or shortening leads to poorer results and arthritis.
- Careful surgical technique and appropriate fixation are essential for optimal patient recovery.