Comminuted articular fractures of the distal radius. Results of conservative treatment

Fifty-nine comminuted articular fractures of the distal radius which had received conservative treatment were reviewed after an average of 3 1/2 years. The results--excellent in 15 patients, good in 30, fair in 12, and poor in 2--were closely linked to the quality of the articular reduction. In patients with a residual malalignment greater than 2 mm, a relatively high incidence of both degenerative arthritis (31%) and unsatisfactory results (56%) was found. The presence of a "die punch" fragment often precluded acceptable fracture reduction and was therefore responsible for many poor clinical and radiographic results. The quality of the extraarticular reduction proved to be of little importance to the final outcome.