Conservative treatment of extra-articular Colles' type fractures of the distal radius: prospective study.

AIM To determine the anatomical and functional results of conservative treatment of extra-articular Colles' type fractures of the distal radius and the borderline value of each anatomical parameter for the best possible correlation with functional end result. METHODS This prospective study included 54 patients. Standard radiographs were made of both wrists in two directions after the fracture, then of the injured side on day 11 following repositioning, and finally of the union of bone segments. Anatomical results were assessed by evaluating the dorsal angulation, loss of radial inclination, and loss of radial length. Functional results were assessed by the evaluation of pain, range of active motion, grip strength, and appearance of the wrist joint. RESULTS Statistically significant association was found between the anatomical and functional results (chi-square=16.3, p<0.001). Excellent or good anatomical and functional results were obtained in 24 patients, whereas in 30 patients both treatment outcomes were assessed as fair or poor. If < or=10 degrees of dorsal angulation was taken as a borderline value for a good outcome, there was significant association with a good functional result (chi-square=23.6, p<0.001). However, if < or=9 degrees loss of radial inclination was taken as a borderline value for a good outcome, no association with a good functional result was found (chi-square=3.9, p=0.530). If < or=6 mm of radial shortening was taken as a borderline value for a good outcome, again no association existed with a good functional result (chi-square=6.43, p=0.011). CONCLUSION We found an association between anatomical and functional results after conservative treatment of extra-articular Colles' type fracture of the distal radius. Acceptable borderline dorsal angulation was < or=9 degrees; acceptable loss of radial inclination was < or=3 degrees, and acceptable loss of radial length was < or=2 mm.