Pain, impaired mobility and weakness in the wrist are common complications after fractures of the lower end of the radius. When these symptoms persist, resection of the distal end of the ulna has been the surgical treatment of choice. 24 patients who had undergone this procedure were reviewed. 50% stated they were not improved by the operation. Of 11 patients with degenerative changes in the distal radio-ulnar joint on preoperative X-ray, 8 stated they were helped by the operation, while of 13 patients without any signs of arthrosis in the distal radio-ulnar joint, only 4 experienced relief of their discomfort. A more discriminating approach to the treatment of the sequelae of fractures to the lower end of the radius is required. Resection of the distal end of the ulna is probably only indicated when the distal radio-ulnar joint shows sings of arthrosis.
In five fresh frozen arm specimens Colles' fracture was simulated by a dorsal wedge osteotomy of the distal radius. A spring load was applied to the cortex of the distal radius fragment exerting a constant traction force in proximal direction. The distal radius fragment showed minimal dorsal angulation as the forearm was positioned in neutral or pronation, assuming the distal radio ulnar joint including its radio ulnar ligament was kept intact. As the forearm was moved into supination the distal fragment angulated dorsally to close the dorsal open gap in spite of the ligament being intact. When the radio ulnar ligament was detached the stability was however lost in any forearm position. The result supports the concept of immobilizing a satisfactorily reduced Colles' fracture in neutral position, possibly in slight pronation but never in supination.
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