Complex Fractures of the Distal Radius

Abstract Objective: Outcome of complex distal radius fractures. Design: Retrospective clinical observation. Setting: Outcome assessment of a clinical series of patients with complex distal radius fractures treated according to a structured, stepwise treatment algorithm. Patients: 17 patients (average age 47 years) with mostly high-energy injuries, 16/17 articular fractures including concomitant carpal injuries, fracture dislocations, extension of the fracture into the diaphysis, and large defects. Intervention: Initial external fixation, followed by soft tissue treatment and further diagnostics and, finally, definitive adapted surgical therapy including combination of external fixation, plates, screws, K-wires, bone graft, and ligament repair. Main Outcome Measurements: DASH, range of motion, radiologic outcome. Results: Average subjective overall performance score (DASH) 16.4 (0–36.7, standard deviation SD] 11.82, 95% confidence interval CI] 8.0–23.6), 73% of the patients back to premorbid work and activities. Conclusions: Using a clearly structured, stepwise approach, complex distal radius fractures can be treated with good clinical outcome preserving hand function.