Fifteen-year outcome of displaced intra-articular fractures of the distal radius.
OBJECTIVE
We previously reported the functional and radiographic outcomes of 21 young adults at an average of 7 years after open reduction and internal fixation of an intra-articular distal radius fracture (original study). The purpose of the current investigation was to evaluate the same cohort at an average of 15 years after surgery to evaluate the effect of additional time on both function and radiographic appearance.


METHODS
We re-evaluated 16 of the original patients at an average of 15 years after surgery. Subjective assessment was performed with the Musculoskeletal Functional Assessment and the Hand Function Sort questionnaires. Objective assessment included a detailed physical examination and strength measurement. Standardized radiographs and computed tomography were used to assess wrist morphology, residual articular step and gap displacement, and the presence and degree of arthrosis.


RESULTS
Subjectively patients continued to function at a high level at the last follow-up evaluation: the average Musculoskeletal Functional Assessment score was 10 and 14 of the 16 patients functioned at a high level according to the Hand Function Sort. Strength and range of motion remained essentially unchanged from the original report. Radiocarpal arthrosis was noted in 13 of the 16 wrists and joint space was reduced an additional 67% compared with the 7-year follow-up evaluation. Nonetheless there continued to be no correlation between the presence or degree of arthrosis and upper-extremity function.


CONCLUSIONS
Radiocarpal arthrosis after intra-articular distal radius fractures can be expected to worsen over time. Despite joint space narrowing and evidence of advanced arthrosis, however, patients maintained a high level of function at the long-term follow-up evaluation.


METHODS
Prognostic, Level II.
Goldfarb
Charles A
CA
Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, Missouri, USA.
Rudzki
Jonas R
JR
Catalano
Louis W
LW
Hughes
Michael
M
Borrelli
Joseph
J
D000203:Activities of Daily Living; D000328:Adult; D001168:Arthritis / Q000000981:diagnostic imaging; D015331:Cohort Studies; D005260:Female; D018737:Hand Strength; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011885:Radius Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D014057:Tomography, X-Ray Computed