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Closed reduction of distal radius fractures: does instability mean irreducibility?
Florian Wichlas1, Norbert P Haas, Tobias Lindner
1Center for Musculoskeletal Surgery, Charité - Universitätsmedizin Berlin, Campus Virchow Clinic, Augustenburger Platz 1, 13353, Berlin, Germany.
Introduction:
The belief that not all distal radius fractures can be initially anatomically reduced with conservative means is rising. The aim of this study was to examine whether adequate reduction with a closed reduction technique is possible and to assess the importance of each step.
Materials And Methods:
We prospectively enrolled 63 distal radius fractures (62 patients). A standardized reduction technique was implemented. Reduction was radiologically evaluated in hanging traction, after reduction, and in plaster. Subgroup analysis was performed for fracture-dependent and fracture-independent factors on their influence on reduction.
Results:
The mean radiological values (radial inclination, dorsal tilt, ulnar variance) showed near anatomic reduction of all fractures in plaster. Fracture severity according to AO classification, initial displacement, number of instability criteria and patient age did not affect the reduction outcome.
Conclusions:
All types of enrolled fractures were nearly anatomically reduced. This contradicts the opinion that some "severe" fractures are too unstable to be initially reduced by closed means.
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