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Arch Hand Microsurg > Volume 18(1); 2013 > Article
Journal of the Korean Society for Surgery of the Hand 2013;18(1):29-36.
Published online March 30, 2013.
DOI: https://doi.org/10.12790/jkssh.2013.18.1.29   
Closed Reduction and Cast Immobilization for the Treatment of Distal Radius Fracture: Does Dorsal Metaphyseal Comminution Predict Radiographic and Functional Outcomes?
Min Gyu Kyung, Ho Wook Chung, Jin Sam Kim, Tan Jun, Jun Bum Lee, Ho Youn Park, In Ho Jeon
1College of Medicine, Kyungpook National University, Daegu, Korea.
2Department of Orthopaedic Surgery, Asan Medical Center, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea. jeonchoi@gmail.com
3Department of Hand Surgery, Affiliated Hospital of Nantong University, Nantong, China.
Received: 1 January 2013   • Revised: 21 February 2013   • Accepted: 26 February 2013
Abstract
Purpose
The purpose of this study was to determine the relationship between dorsal metaphyseal comminution and the radiographic and functional outcomes of patients with distal radius fractures treated by closed reduction and cast immobilization.

Methods
Twenty-six patients with acute distal radius fractures were retrospectively reviewed. The mean age of this patient group was 62.8 years (range, 45-87 years). Eighteeen cases were AO type-A3 and 8 were AO type-A2. Radiographic and functional parameters were analyzed and compared between the patients who presented with or without dorsal metaphyseal comminution on their initial radiographs in order to assess the clinical outcomes. The radiographic parameters included radial inclination, radial length, volar/dorsal tilt, and ulnar variance. In order to measure the functional outcomes, each patient's range of motion, grip strength, Quick disabilities of the arm, shoulder, and hand (DSAH), visual analog scale (VAS), and Mayo score were determined.

Results
Seventeen patients (65%) presented with dorsal metaphyseal comminution on the initial radiographs. Radial inclination, radial length, and volar/dorsal tilt were decreased and ulnar variance was increased on the final radiographs in comparison with the postreduction. However, there were no statistically significant differences between the two groups that presented with or without dorsal metaphyseal comminution (p>0.05). None of the functional parameters (i.e., range of motion, grip strength, DASH, Mayo, and VAS score) were significantly different between the two groups (p>0.05).

Conclusion
Dorsal metaphyseal comminution seems to have no significant impact on radiographic and functional outcomes when closed reduction and cast immobilization was planned for the treatment of distal radius fracture.
 
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