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. 2024 Nov 22;16(11):e74226.
doi: 10.7759/cureus.74226. eCollection 2024 Nov.

Functional Outcomes in the Distal End of Radius Fracture: A Prospective Study in a Tertiary Care Center

Varun Thusoo  1 , Arjun S Chakrapani  2 , Ashish Nehru  3 , Sachin Kudyar  4 , Brahmpreet Nagpal  5 , Alok Kv  6 , Ebin S  6 , Akhil Jose  7
Affiliations

Functional Outcomes in the Distal End of Radius Fracture: A Prospective Study in a Tertiary Care Center

Varun Thusoo et al. Cureus. .

Abstract

Objectives: The objectives of this study are to determine the functional outcomes and compare them between conservative and surgical management in patients managed for closed-type intra-articular distal end of radius fractures.

Methods: A prospective observational study was done on 150 patients who underwent treatment for closed-type intra-articular distal end of radius fractures. As per Frykman Classification, they were type III. Patients were either managed conservatively, i.e. 100 patients out of 150 and surgical management was done in 50 cases. For surgical management, implants used were K-wires, Schanz pins, and Ellis Plate. The functional outcomes were noted in terms of pain and range of motion, in the follow up of six months. Union was noted clinically and radiologically.

Results: The mean age of the study patients was 42.32 ± 15.77 years. Out of 150 patients, there were 100 (66.67%) male patients. Compared to conservative management, surgical management had significantly lesser time of union (12 vs. 20 weeks, P<0.0001); significantly more excellent results (44% vs. 30%), more good results (32% vs. 15%) (P=0.003); comparable pain score (P=0.236); and comparable functional score (P=0.661). Regarding radiological outcomes, surgical management had significantly more volar tilt (9.6±2.5° vs. 8±5°, P=0.035); lesser Ulnar variance (3±2 vs. 4±2 mm, P=0.004), lesser grip strength <50% (26% vs. 65%, P<0.0001); comparable radial inclination (21±4° vs. 20±5°, P=0.661); and comparable radial height (11±3 vs. 10±5 mm, P=0.195) Conclusion: To conclude, surgery for distal radius fractures promotes faster healing, lesser pain, lesser malunion, and better functional outcomes. However, it is not without potential risks. Non-surgical treatment is still a suitable option, for patients with contraindications to surgery or having lower need for functional improvement.

Keywords: conservative treatment; distal radius fracture; functional outcomes; radiographic outcomes; surgical treatment.

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Conflict of interest statement

Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Institutional Ethical Committee, Jammu issued approval IEC/GMC/2022/8/8. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Statistical analysis
SPSS:  IBM SPSS Statistics for Windows, Version 24 (Released 2016; IBM Corp., Armonk, New York, United States) Data normality was assessed by the Shapiro-Wilk test. Statistical significance: p< 0.05
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