RESUMEN
INTRODUCTION: Ligamentous lesions are concomitant to dislocated distal radius fractures in a high percentage. The purpose of this study was to evaluate the relevance of intracarpal lesions. METHODS: Seventy eight of an original cohort of 104 distal radius fractures (74%) were studied over a follow-up period of one year after surgery with complete data (X-rays, CT, MRI, follow-up X-rays and questionnaire). RESULTS: Most of our radius fractures (AO 23 type: A 39, B 9, C 30) present additional lesions: 97%. One-year evaluation showed an average Castaing score of 4.5 ± 2.5 points, means a "good" result of a scale of 0-27. Fifty five of seventy eight had an "excellent" or "good" result (<6 points). No patient had more than 12 points ("fair"). CONCLUSIONS: The dislocated distal radial fracture implies severe and complex injury to the whole wrist, mostly concerning intracarpal concomitant lesions (MRI). Surgical therapy of dislocated radius fractures followed by 6 weeks relief through thermoplastic splint seems to be sufficient to achieve good 1-year results. MRI-detectable carpal lesions at the time of the radial fracture are common, but only a few of them seem to decompensate later, give symptoms and became of therapeutic relevance.
Asunto(s)
Huesos del Carpo/diagnóstico por imagen , Luxaciones Articulares/cirugía , Ligamentos/diagnóstico por imagen , Fracturas del Radio/cirugía , Traumatismos de la Muñeca/diagnóstico , Articulación de la Muñeca/diagnóstico por imagen , Adulto , Anciano , Anciano de 80 o más Años , Huesos del Carpo/patología , Estudios de Cohortes , Femenino , Humanos , Luxaciones Articulares/complicaciones , Luxaciones Articulares/diagnóstico , Ligamentos/patología , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Fracturas del Radio/complicaciones , Fracturas del Radio/diagnóstico , Rango del Movimiento Articular , Tomografía Computarizada por Rayos X , Resultado del Tratamiento , Traumatismos de la Muñeca/complicaciones , Articulación de la Muñeca/patología , Adulto JovenRESUMEN
BACKGROUND: The functional outcome of surgically treated dislocated fractures of the distal radius is limited and does not correlate with radiographic results. Additional carpal lesions are assumed to be the cause. This study has evaluated which carpal lesions are associated with dislocated fractures of the distal radius. MATERIAL AND METHODS: A total of 104 consecutive patients with dislocated fractures of the distal radius were included in the study. The injured wrist was examined by radiography, computed tomography (CT) and magnetic resonance imaging (MRI) to determine additional carpal lesions. RESULTS: Radiographically 51 of the 104 fractures presented as type A according to the AO classification, 10 as type B and 39 as type C. The CT scan detected that only 5 of the 51 type A fractures were exclusively metaphyseal fractures. All type A fractures were associated with ligamental lesions in MRI. CONCLUSIONS: The results of the study confirm the hypothesis that every dislocated fracture of the distal radius is a combined carpal trauma associated with additional osseous and/or ligamental lesions.