[Orthopedic treatment of fractures of the lower extremity of the radius by the Judet technique. Anatomic results in function of the type of lesion: apropos of 280 cases].
OBJECTIVE
The authors evaluated the anatomical results and limits of the conservative treatment for displaced Colle's fracture.


METHODS
The anatomical results of 280 consecutive fractures were retrospectively analysed. Conservative treatment was performed according to Judet. Stability of the reduction was assessed for grade 0, 1, 2 of Kapandji's classification. Radiographical mean follow-up for all patient was three months (2 months to 8 years).


RESULTS
In 122 cases (64 per cent) mal-union was observed. Mal-union was due in 93.5 per cent of cases (114) to secondary displacement of the distal fragment and in 6.5 per cent (8 cases) to poor reduction. Secondary displacement was essentially posterior in the sagittal plane. The principal factors of instability were radial shortening superior to 3 mm (p = 0.005), patient age of 55 years of more (p = 0.004), metaphyseal comminution (p = 0.004) and degree of primary displacement in the frontal plane (p = 0.01). Stability after reduction was determined by crossing the distal fragment in relation to the anterior cortex of the proximal fragment. There were 10.5 per cent algodystrophies and 9 per cent median nerve paresthesiae which were avoided by 45 degrees of wrist flexion.


CONCLUSIONS
Judet's conservative treatment is indicated in extra-articular Colle's fractures (grade 0, 1, 2 of Kapandji's classification), after evaluation of factors of instability, secondary displacement and mal-union. Minor mal-unions may be well tolerated, and do not seem to affect wrist function with 3 mm of radial shortening and 10 degrees of radial glenoid posterior angulation on the sagittal plane.
Service de Chirurgie Orthopédique, Traumatologique et Réparatrice, Hôpital de la Pitié, Paris.
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Camelot
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Ramaré
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Lemoine
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Saillant
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D003100:Colles' Fracture / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D005260:Female; D005592:Fracture Fixation / Q000379:methods*; D018460:Fractures, Comminuted / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D005599:Fractures, Ununited / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D006801:Humans; D007593:Joint Instability / Q000209:etiology; D008297:Male; D008875:Middle Aged; D011859:Radiography; D011885:Radius Fractures / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies
Traitement orthopédique des fractures de l'extrémité inférieure du radius selon Judet. Résultats anatomiques en fonction des types lésionnels: à propos de 280 cas.