title: Closed reduction of distal radius fractures: does instability mean irreducibility?
abstract: BACKGROUND
  The belief that not all distal radius fractures can be initially anatomically reduced with conservative means is rising. The aim of this study was to examine whether adequate reduction with a closed reduction technique is possible and to assess the importance of each step.
  
  
  METHODS
  We prospectively enrolled 63 distal radius fractures (62 patients). A standardized reduction technique was implemented. Reduction was radiologically evaluated in hanging traction, after reduction, and in plaster. Subgroup analysis was performed for fracture-dependent and fracture-independent factors on their influence on reduction.
  
  
  RESULTS
  The mean radiological values (radial inclination, dorsal tilt, ulnar variance) showed near anatomic reduction of all fractures in plaster. Fracture severity according to AO classification, initial displacement, number of instability criteria and patient age did not affect the reduction outcome.
  
  
  CONCLUSIONS
  All types of enrolled fractures were nearly anatomically reduced. This contradicts the opinion that some "severe" fractures are too unstable to be initially reduced by closed means.
authors: Center for Musculoskeletal Surgery, Charité - Universitätsmedizin Berlin, Campus Virchow Clinic, Augustenburger Platz 1, 13353, Berlin, Germany.
authors: Florian
authors: F
authors: Wichlas
authors: Norbert P
authors: NP
authors: Haas
authors: Tobias
authors: T
authors: Lindner
authors: Serafim
authors: S
authors: Tsitsilonis
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008349:Manipulation, Orthopedic; D008875:Middle Aged; D011446:Prospective Studies; D011885:Radius Fractures / Q000628:therapy*; D016896:Treatment Outcome; D055815:Young Adult