Distal Radius Eklem İçi Kırıklarının El Bilek Fiksatörü ile Tedavisinde Radio-Ulnar Açıdaki Değişikliklerin El Bilek Skorlamasına Etkisi

Abstract

Aim: This study was aimed to evaluate the effect of radial inclination (RI) angle, assessed with radiological measurement, on the clinical outcomes of intra-articular fractures of the distal radius (IFDR) treated with closed reduction and penning type dynamic wrist fixator. Material and Methods: A total of 120 patients who underwent closed reduction and dynamic wrist fixation due to IFDR between 2012 and 2020 were retrospectively reviewed. The effects of the changes in RI on clinical outcomes according to Mayo wrist scoring (MWS) criteria were investigated by measuring the RI angles in anteroposterior wrist radiographs of the patients at postoperative 2nd, 6th, and 10th weeks. Results: According to the AO fracture classification, 77 (64.2%) of the patients had type C1 and 43 (35.8%) of the patients had type C2 fracture. The patients comprised 69 (57.7%) females and 51 (42.3%) males, and the mean age was 50.08±15.36 years. Fixators were removed at six weeks. RI angles measured at post-op week 10 were 20°-30° in 83 (69.1%) patients, 10°-19° in 32 (26.6%) patients, and 0°-9° in 5 (4.3%) patients. According to MWS, 39 (32.5%) patients were evaluated as excellent, 76 (63.3%) patients as good, and 5 (4.2%) patients as moderate. A statistically significant positive correlation was observed between RI values and MWS (r=0.369, p<0.001). Conclusion: Dynamic wrist fixation with closed reduction is a simple and minimally invasive method, and provides successful clinical and functional results in the treatment of IFDR. We consider that optimal RI angles are effective in clinical and functional outcomes.