[Distal radius fracture--indications for conservative, partial surgical and surgical therapy]

460 fractures of the distal radius including 91 which are treated surgically are investigated in a retrospective study. There were 260 fractures of the left and only 200 of the right radius. 66% of the patients were female, especially striking is the superior number of women older than 45 years. The evaluation of the final radiological results referring to anatomical joint angles and normal radius length shows a high correlation to the evaluation of the final functional results. 70% of the latter are valued as excellent or good, 19% as tolerable and 11% as poor. The classification according to Frykman shows a significantly better result for cases without violation of the distal ulna. The comparison between operative and non-operative treatment of dislocated fractures without infraction of the radiocarpal joint demonstrates good results of percutaneous wire fixation in those cases. The therapy of fractures with infraction of radiocarpal and radioulnar joint is difficult. In this group we could not find a superiority of operative against conservative treatment. Wire fixation lead to 19% poor results and cannot be recommended for all cases. Six patients treated by external fixation and five treated by osteosynthesis using metal plates had good or tolerable results. The indication for using these methods has to be considered.