title: The relationship between initial closed reduction and the surgical reconstruction of the radiocarpal joint line in distal radial fractures.
abstract: BACKGROUND
  Whilst initial closed reduction followed by definitive open fixation is widely applied in the treatment of distal radial fractures, the effect of the closed reduction on the reconstruction of the articular surface remains unclear. Our research questions were:
  
  
  METHODS
  Palmar tilt and radiocarpal inclination of 425 patients were measured at admission, following initial closed reduction and after surgical reconstruction.
  
  
  RESULTS
  Closed reduction increased palmar tilt by 12.1° and radial inclination by 2.7°. Open surgical reduction further corrected palmar tilt by 17.88° and radial inclination by 3.5°. Whilst there was no association between postoperative palmar tilt and initially achieved closed reduction, a significant association between radial inclination following closed reduction and surgical fixation was found.
  
  
  CONCLUSIONS
  Our retrospective study challenges the existence of a relationship between the initial closed reduction and the reconstruction of the anatomic joint line in surgically treated distal radial fractures.
authors.affiliation: Department of Trauma, Hand and Reconstructive Surgery, University Medical center Marburg, Baldingerstraße, 35043 Marburg, Germany.
authors.forename: P
authors.initials: P
authors.lastname: Lechler
authors.affiliation: Department of Trauma, Hand and Reconstructive Surgery, University Medical center Marburg, Baldingerstraße, 35043 Marburg, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Börsch
authors.affiliation: Institute for Medical Biometry and Epidemiology, Philipps-University, Marburg, Germany.
authors.forename: N
authors.initials: N
authors.lastname: Timmesfeld
authors.affiliation: Department of Trauma, Hand and Reconstructive Surgery, University Medical center Marburg, Baldingerstraße, 35043 Marburg, Germany.
authors.forename: T
authors.initials: T
authors.lastname: Schwarting
authors.affiliation: Department of Orthopaedic and Trauma Surgery, University Hospital of Cologne, Cologne, Germany.
authors.forename: C K
authors.initials: CK
authors.lastname: Boese
authors.affiliation: Department of Trauma, Hand and Reconstructive Surgery, University Medical center Marburg, Baldingerstraße, 35043 Marburg, Germany. Electronic address: michaelfrink@web.de.
authors.forename: M
authors.initials: M
authors.lastname: Frink
mesh_terms: D001696:Biomechanical Phenomena; D001860:Bone Plates; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods; D017102:Fracture Healing; D005858:Germany; D006784:Hospitals, Teaching; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D011885:Radius Fractures / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D016059:Range of Motion, Articular; D020127:Recovery of Function; D012189:Retrospective Studies; D016896:Treatment Outcome; D014955:Wrist Joint / Q000000981:diagnostic imaging / Q000503:physiopathology
keywords: Closed reduction; Distal radial fracture; Internal fixation; Palmar tilt; Radial inclination; Radiocarpal joint