Clinical Analysis of Intraarticular Fractures of Distal Radius.

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We have heated 31 patients with intraarticular fractures of the distal radius in a ten year penod. Fractures were classified according to Saito's classification. Gartland's criterion was employed for the clinical evaluation; Sakagami's criterion for morphological evaluation, and Knirk's criterion for evaluation of the remaining displacement of the articular surface.In general, clinical results were excellent or good in those reduced by open reduction and fixed internally. Morphological evaluation and the remaining displacement of the articular surface interfers with the clinical results. Osteoarthritic changes were observed in 75% of the patients with remaining displacement more than 2mm. Therefore permissible displacement was supposed to be within 2mm. In simple intraarticular fractures, clinical results in the conservatively treated group were similar to those in operatively treated group. However, in the comminuted intraarticular fractures, clinical results were distinctively successful in the group reduced by open reduction and fixed internally compared to other groups. Especially in the dorsal split depression or central depression fractures, reductions of the depressed fragment were insufficient with external fixation only. Although correct reduction is extremely difficult, open reduction with anatomical restoration of the articular surface and fixation is important in this type of fracture.
西日本整形・災害外科学会の論文