Redisplacement of Distal Radius Fracture after Initial Closed Reduction: Analysis of Prognostic Factors.
BACKGROUND
To evaluate risk factors of redisplacement and remind surgeons of key factors regarding conservative treatment of distal radius fracture.


METHODS
A total of 132 patients who received conservative treatment for distal radius fractures between March 2008 and February 2011 were included in this study. Radial inclination, radial length, volar tilting angle, ulnar variance, fragment translation, and presence of dorsal metaphyseal comminution were measured on the X-rays taken immediately after reduction, one week after injury during the first follow-up outpatient clinic visit, and after the gain of radiological union. Secondary displacement was defined as a loss of reduction during the follow-up period, and was divided into 'early' and 'late' categories. We analyzed the influence of initial displacement radiologic variables, dorsal cortex comminution, and patient age on the development of secondary displacement.


RESULTS
Development of secondary displacement was significantly associated only with initial displacement radiologic variables (p < 0.001), development of the late secondary displacement was significantly associated with age (p = 0.005), and initial displacement radiologic variables were associated significantly with a serial increase in ulnar variance (p = 0.003).


CONCLUSIONS
Greater displacement on the initial radiographs indicates a higher possibility of development for secondary displacement, and older patients had a higher probability of late secondary displacement development. Furthermore, dorsal comminutions did not affect secondary displacement directly.
Department of Orthopaedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Ho-Wook
HW
Jung
Department of Orthopaedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Hanpyo
H
Hong
Department of Orthopaedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Hong Jun
HJ
Jung
Department of Orthopaedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Jin Sam
JS
Kim
Department of Orthopedic Surgery, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu, Korea.
Ho Youn
HY
Park
Department of Orthopaedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Kun Hyung
KH
Bae
Department of Orthopaedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
In-Ho
IH
Jeon
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D005593:Fracture Fixation, Internal; D018460:Fractures, Comminuted / Q000000981:diagnostic imaging / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011859:Radiography; D011885:Radius Fractures / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000628:therapy*; D013165:Splints; D055815:Young Adult
Fractures comminuted; Radius fractures; Splints