[Treatment results after surgical therapy of distal radius fractures]

Fractures of the distal radius are being surgically treated with increasing frequency, because of the poor results yielded by cast treatment. Using the AO fracture classification as a basis, we present a treatment regimen for these fractures. For surgical interventions we prefer closed reduction and osteosynthesis with, for ex percutaneous K-wire fixation, intrafocal (Kapandji) pinning, minimal open screw osteosynthesis, fixateur externe and combined methods; only fractures of type B2 and B3 will be treated by open reduction and application of an internal plate. In addition, we present the results of a follow-up examination in 100 patients (85 female, 15 male) with radius fractures treated operatively: their average age was 59 years (range 18-91) and the average follow-up period was 21 months (range 12-36). According to the AO classification we found mostly fractures were of type A3.2 (n = 40) and type C2.2 (n = 23). We selected the method of osteosynthesis in dependence on the AO classification. The functional result was judged according to Sarmiento's modification of the Gartland and Werley score. The overall results were excellent or good in 80% of the patients, only 7% had a moderate result; none of the patients had a poor result. The radiological result was measured by the Lidström score: 97%, grade I and II; only 2%, grade III; 1% grade IV. Our results have shown that anatomical reduction of the fracture is essential if a good functional result is to be obtained.