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Fractures of the Distal Radius and Distal Radioulnar Joint

  • Douglas A. CampbellEmail author
  • Louise A. Crawford
Chapter

Abstract

Fractures of the distal radius are amongst the most common fractures seen in everyday orthopaedic practice. They were originally thought to be simple dislocations in the days prior to radiographic examination. The French physician, JL Petit, challenged this view in 1705, when he proposed that these post-traumatic deformities were actually caused by fractures of the bones and not dislocations of the joints. Some years later, the ideas of Claude Pouteau (published posthumously in 1783) supported this theory;

Keywords

Fracture Radius Wrist Ulna Articular Insufficiency Associated injuries Classification Imaging Distal radioulnar joint Columnar theory Angular stability Variable angle 

References

  1. 1.
    Frykman G. Fractures of the distal radius, including sequelae – shoulder and finger syndrome, disturbance in the distal radioulnar joint and impairment of nerve function: a clinical and experimental study. Acta Orthop Scand Suppl. 1967;108:1–155.CrossRefGoogle Scholar
  2. 2.
    Rikli DA, Regazzoni P. Fractures of the distal end of the radius treated by internal fixation and early function. A preliminary report of 20 cases. J Bone Joint Surg (Br). 1996;78B:588–92.Google Scholar
  3. 3.
    Pechlaner S, Kathrein A, Gabl M, Lutz M, Angermann P, Zimmermann R, Peer R, Peer S, Rieger M, Freund M, Rudisch A. Distal radius fractures and concomitant injuries: experimental studies concerning pathomechanisms. J Hand Surg (Br). 2002;28B:609–16.Google Scholar
  4. 4.
    Tanabe K, Nakajima T, Sogo E, Denno K, Horiki M, Nakagawa R. Intra-articular fractures of the distal radius evaluated by computed tomography. J Hand Surg (Am). 2011;36A:1798–803.CrossRefGoogle Scholar
  5. 5.
    Melone CJ. Distal radius fractures: patterns of articular fragmentation. Orthop Clin North Am. 1993;24:239–53.PubMedGoogle Scholar
  6. 6.
    Knirk JL, Jupiter JB. Intra-articular fractures of the distal end of the radius in young adults. J Bone Joint Surg (Am). 1986;68A:657–9.Google Scholar
  7. 7.
    Haus BM, Jupiter JB. Intra-articular fractures of the distal end of the radius in young adults: re-examined as evidence based and outcomes medicine. J Bone Joint Surg (Am). 2009;91A:2984–91.CrossRefGoogle Scholar
  8. 8.
    Mandziak DG, Watts AC, Bain GI. Ligament contribution to patterns of articular fractures of the distal radius. J Hand Surg (Am). 2011;36A:1621–5.CrossRefGoogle Scholar
  9. 9.
    Lochmüller EM, Matsuura M, Bauer J, Hitzl W, Link TM, Müller R, Eckstein F. Site-specific deterioration of trabecular bone architecture in men and women with advancing age. J Bone Miner Res. 2008;23:1964–73.PubMedCrossRefGoogle Scholar
  10. 10.
    Stoffelen D, De Smet L, Broos P. The importance of the distal radioulnar joint in distal radial fractures. J Hand Surg (Br). 1998;23B:507–11.CrossRefGoogle Scholar
  11. 11.
    Müller ME, Nazarian S, Koch P, Schatzker J. The comprehensive classification of fractures of long bones. Berlin: Springer; 1990.CrossRefGoogle Scholar
  12. 12.
    Altissimi A, Azzara A, Mancini GB, Pierdominici P. The reliability of classification of articular fractures of the distal radius. J Hand Surg (Br). 1996;21B Suppl 1:31.Google Scholar
  13. 13.
    Jupiter JB, Fernandez DL. Comparative classification for fractures of the distal end of the radius. J Hand Surg (Am). 1997;22A:563–71.CrossRefGoogle Scholar
  14. 14.
    Naqvi SGA, Reynolds T, Kitsis C. Interobserver reliability and intraobserver reproducibility of the Fernandez classification for distal radius fractures. J Hand Surg (Eur). 2009;34E:483–5.CrossRefGoogle Scholar
  15. 15.
    Lafontaine M, Hardy D, Delince P. Stability assessment of distal radius fractures. Injury. 1989;20:208–10.PubMedCrossRefGoogle Scholar
  16. 16.
    Altissimi M, Mancini GB, Azzara A, Ciaffoloni E. Early and late displacement of fractures of the distal radius: the prediction of instability. Int Orthop. 1994;18:61–5.PubMedCrossRefGoogle Scholar
  17. 17.
    Barton T, Chambers C, Bannister G. A comparison between subjective outcome score and moderate radial shortening following a fractured distal radius in patients of mean age 69 years. J Hand Surg (Eur). 2007;32E:165–9.CrossRefGoogle Scholar
  18. 18.
    Abbaszadegan H, Jonsson U, von Sivers K. Prediction of instability of Colles’ fractures. Acta Orthop Scand. 1989;60:646–50.PubMedCrossRefGoogle Scholar
  19. 19.
    Young CE, Nanu AM, Checketts RG. Seven year outcome following Colles’ type distal radial fracture: a comparison of two treatment methods. J Hand Surg (Br). 2003;28B:422–6.CrossRefGoogle Scholar
  20. 20.
    Batra S, Gupta A. The effect of fracture-related factors on the functional outcome at 1 year in distal radius fractures. Injury. 2002;33:499–502.PubMedCrossRefGoogle Scholar
  21. 21.
    Gliatis JD, Plessas SJ, Davis TRC. Outcome of distal radial fractures in young adults. J Hand Surg (Br). 2000;25B:535–43.CrossRefGoogle Scholar
  22. 22.
    McQueen MM, Hajducka C, Court-Brown CM. Redisplaced unstable fractures of the distal radius: a prospective randomized comparison of four methods of treatment. J Bone Joint Surg (Br). 1996;78B:404–9.Google Scholar
  23. 23.
    Ng CY, McQueen MM. What are the radiological predictors of functional outcome following fractures of the distal radius? J Bone Joint Surg (Br). 2011;93B:145–50.CrossRefGoogle Scholar
  24. 24.
    Gartland J, Werley C. Evaluation of healed Colles’ fractures. J Bone Joint Surg (Am). 1951;33:895–907.Google Scholar
  25. 25.
    Kwok IHY, Leung F, Yuen G. Assessing results after distal radius fracture treatment: a comparison of objective and subjective tools. Geriatr Orthop Surg Rehabil. 2011;2:155–60.PubMedCrossRefPubMedCentralGoogle Scholar
  26. 26.
    Beaule PE, Dervin GF, Giachino AA, Rody K, Grabowski J, Fazekas A. Self reported disability following distal radius fractures: the influence of hand dominance. J Hand Surg (Am). 2000;25A:476–82.CrossRefGoogle Scholar
  27. 27.
    Fujii K, Henmi T, Kanematsu Y, Mishiro T, Sakai T, Terai T. Fractures of the distal end of radius in elderly patients: a comparative study of anatomical and functional results. J Orthop Surg (Hong Kong). 2002;10:9–15.Google Scholar
  28. 28.
    Karnezis IA, Fragkiadakis EG. Association between objective clinical variables and patient-rated disability of the wrist. J Bone Joint Surg (Br). 2002;84B:967–70.CrossRefGoogle Scholar
  29. 29.
    Grewal R, MacDermid JC. The risk of adverse outcomes in extra-articular distal radius fractures is increased with malalignment in patients of all ages but mitigated in older patients. J Hand Surg (Am). 2007;32A:962–70.CrossRefGoogle Scholar
  30. 30.
    Robertson GA, Robertson BF, Thomas B, McEachan J, Davidson DM. Assessing angulation on digital images of radiographs of fractures of the distal radius: visual estimation versus computer software measurement. J Hand Surg (Eur). 2011;36E:230–5.CrossRefGoogle Scholar
  31. 31.
    Yang Z, Mann FA, Gilula LA, Haerr C, Larsen CF. Scaphopisocapitate alignment: criterion to establish a neutral lateral view of the wrist. Radiology. 1997;205:865–9.PubMedCrossRefGoogle Scholar
  32. 32.
    Capo JT, Accousti K, Jacob G, Tan V. The effect of rotational malalignment on x-rays of the wrist. J Hand Surg (Eur). 2009;34E:166–72.CrossRefGoogle Scholar
  33. 33.
    Kaempfe FA, Walker KM. External fixation for distal radius fractures: effect of distraction on outcome. Clin Orthop. 2000;1(380):220–5.CrossRefGoogle Scholar
  34. 34.
    Lundy DW, Quisling SG, Lourie GM, Feiner CM, Lins RE. Tilted lateral radiographs in the evaluation of intra-articular distal radius fractures. J Hand Surg (Am). 1999;24A:249–56.CrossRefGoogle Scholar
  35. 35.
    Pruitt DL, Gilula LA, Manske PR, Vannier MW. Computed tomography scanning with image reconstruction in evaluation of distal radius fractures. J Hand Surg (Am). 1994;19A:720–7.CrossRefGoogle Scholar
  36. 36.
    Cole RJ, Bindra RR, Evanoff BA, Gilula LA, Yamaguchi K, Gelberman RH. Radiographic evaluation of osseous displacement following intra-articular fractures of the distal radius: reliability of plain radiography versus computed tomography. J Hand Surg (Am). 1997;22A:792–800.CrossRefGoogle Scholar
  37. 37.
    Adams B. Effects of radial deformity on distal radioulnar joint mechanics. J Hand Surg (Am). 1993;18A:492–8.CrossRefGoogle Scholar
  38. 38.
    Short WH, Palmer AK, Werner FW, Murphy DJ. A biomechanical study of distal radial fractures. J Hand Surg (Am). 1987;12A:529–43.CrossRefGoogle Scholar
  39. 39.
    Kihara H, Palmer AK, Werner FW, Short WH, Fortino MD. The effect of dorsally angulated distal radius fractures on distal radioulnar joint congruency and forearm rotation. J Hand Surg (Am). 1996;21A:40–7.CrossRefGoogle Scholar
  40. 40.
    Bong MR, Egol KA, Leibman M, Koval KJ. A comparison of immediate postreduction splinting constructs for controlling initial displacement of fractures of the distal radius. J Hand Surg (Am). 2006;31A:766–70.CrossRefGoogle Scholar
  41. 41.
    Stewart HD, Innes AR, Burke FD. Functional cast-bracing for Colles fractures. J Bone Joint Surg (Br). 1984;66B:749–53.Google Scholar
  42. 42.
    Wahlstrom O. Treatment of Colles fractures. Acta Orthop Scand. 1982;53:225–8.PubMedCrossRefGoogle Scholar
  43. 43.
    Koenig KM, Davis GC, Grove MR, Tosteson ANA, Koval KJ. Is early internal fixation preferred to cast treatment for well-reduced unstable distal radial fractures? J Bone Joint Surg (Am). 2009;91:2086–93.CrossRefGoogle Scholar
  44. 44.
    Hull P, Baraza N, Gohil M, Whalley H, Mauffrey C, Brewster M, Costa ML. Volar locking plates versus K-wire fixation of dorsally displaced distal radius fractures – a functional outcome study. J Trauma. 2011;70:E125–8.PubMedCrossRefGoogle Scholar
  45. 45.
    Kreder HJ, Agel J, McKee MD, Schemitsch EH, Stephen D, Hanel DP. A randomized, controlled trial of distal radius fractures with metaphyseal displacement but without joint incongruity: closed reduction and casting versus closed reduction, spanning external fixation, and optional percutaneous K-wires. J Orthop Trauma. 2006;20:115–21.PubMedCrossRefGoogle Scholar
  46. 46.
    Kristiansen TK, Ryaby JP, McCabe J, Frey JJ, Roe LR. Accelerated healing of distal radial fractures with the use of specific, low-intensity ultrasound. A multicenter, prospective, randomized, double-blind, placebo-controlled study. J Bone Joint Surg (Am). 1997;79A:961–73.Google Scholar
  47. 47.
    Trumble TE, Schmitt SR, Vedder NB. Factors affecting functional outcome of displaced intra-articular distal radius fractures. J Hand Surg (Am). 1994;19:325–40.CrossRefGoogle Scholar
  48. 48.
    Altissimi M, Mancini GB, Ciaffoloni E, Pucci G. Comminuted articular fractures of the distal radius: results of conservative treatment. Ital J Orthop Traumatol. 1991;17:117–23.PubMedGoogle Scholar
  49. 49.
    Catalano LW, Cole RJ, Gelberman RH, Evanoff BA, Gilula LA, Borrelli J. Displaced intra-articular fractures of the distal aspect of the radius. Long-term results in young adults after open reduction and internal fixation. J Bone Joint Surg (Am). 1997;79A:1290–302.Google Scholar
  50. 50.
    Fernandez DL, Geissler WB. Treatment of displaced articular fractures of the radius. J Hand Surg (Am). 1991;16A:375–84.CrossRefGoogle Scholar
  51. 51.
    Jupiter JB, Marent-Huber M. Operative management of distal radial fractures with 2.4 millimeter locking plates: a multi-center prospective case series. J Bone Joint Surg (Am). 2009;91A:55–65.CrossRefGoogle Scholar
  52. 52.
    Lindau T, Arner M, Hagberg L. Intra articular lesions in distal fractures of the radius in young adults. J Hand Surg (Br). 1997;22B:638–43.CrossRefGoogle Scholar
  53. 53.
    Mehta JA, Slavotinek JP, Krishnan J. Local osteopenia associated with management of intra-articular distal radial fractures by insertion of external fixation pins in the distal fragment: prospective study. J Orthop Surg (Hong Kong). 2002;10:179–84.Google Scholar
  54. 54.
    Salter RB, Simmonds DF, Malcolm BW, Rumble EJ, MacMichael D, Clements ND. The biological effect of continuous passive motion on the healing of full-thickness defects in articular cartilage: an experimental investigation in the rabbit. J Bone Joint Surg (Am). 1980;62A:1232–51.Google Scholar
  55. 55.
    Jakob M, Rikli DA, Regazzoni P. Fractures of the distal radius treated by internal fixation and early function. A prospective study of 73 consecutive patients. J Bone Joint Surg (Br). 2000;82B:340–4.CrossRefGoogle Scholar
  56. 56.
    Leung F, Tu Y, Chew WYC, Chow SP. Comparison of external and percutaneous pin fixation with plate fixation for intra-articular distal radius fractures: a randomized study. J Bone Joint Surg (Am). 2008;90A:16–22.CrossRefGoogle Scholar
  57. 57.
    Kreder HJ, Hanel DP, Agel J, McKee M, Schemitsch EH, Trumble TE, Stephen D. Indirect reduction and percutaneous fixation versus open reduction and internal fixation for displaced intra-articular fractures of the distal radius: a randomized, controlled trial. J Bone Joint Surg (Br). 2005;87B:829–36.CrossRefGoogle Scholar
  58. 58.
    Grewal R, Perey B, Wilmink M, Stothers K. A randomized prospective study on the treatment of intra-articular distal radius fractures: open reduction and internal fixation with dorsal plating versus mini open reduction, percutaneous fixation, and external fixation. J Hand Surg (Am). 2005;30A:764–72.CrossRefGoogle Scholar
  59. 59.
    Chung KC, Watt AJ, Kotsis SV, Marqaliot Z, Haase SC, Kim HM. Treatment of unstable distal radial fractures with the volar locking plating system. J Bone Joint Surg (Am). 2006;88A:2687–94.CrossRefGoogle Scholar
  60. 60.
    Arora R, Lutz M, Hennerbichler A, Krappinger D, Espen D, Gabl M. Complications following internal fixation of unstable distal radius fracture with a palmar locking plate. J Orthop Trauma. 2007;21:316–22.PubMedCrossRefGoogle Scholar
  61. 61.
    Campbell DA. Open reduction and internal fixation of intra-articular and unstable fractures of the distal radius using the AO distal radius plate. J Hand Surg (Br). 2000;25B:528–34.CrossRefGoogle Scholar
  62. 62.
    Orbay JL, Fernandez DL. Volar fixation for dorsally displaced fractures of the distal radius. J Hand Surg (Am). 2002;27A:205–15.CrossRefGoogle Scholar
  63. 63.
    Tada K, Ikeda K, Shigemoto K, Suganuma S, Tsuchiya H. Prevention of flexor pollicis longus tendon rupture after volar plate fixation of distal radius fractures. Hand Surg. 2011;16:271–5.PubMedCrossRefGoogle Scholar
  64. 64.
    Sügün TS, Karabay N, Gürbüz K, Özaksar T, Toros T, Kayalar M. Screw prominences related to plamar locking plating of distal radius. J Hand Surg (Eur). 2011;36:320–4.CrossRefGoogle Scholar
  65. 65.
    Pichler W, Windisch G, Schaffler R, Rienmüller R, Grechenig W. Computer aided 3D analysis of the distal dorsal radius surface and the effects on volar plate osteosynthesis. J Hand Surg (Eur). 2009;34E:598–602.CrossRefGoogle Scholar
  66. 66.
    Drobetz H, Bryant AL, Pokorny T, Spitaler R, Leixnering M, Jupiter JB. Volar fixed-angle plating of distal radius extension fractures: influence of plate position on secondary loss of reduction – a biomechanic study in a cadaveric model. J Hand Surg (Am). 2006;31A:615.e1–e9.Google Scholar
  67. 67.
    Harness NG, Jupiter JB, Orbay JL, Raskin KB, Fernandez DL. Loss of fixation of the volar lunate facet fragment in fractures of the distal part of the radius. J Bone Joint Surg (Am). 2004;86A:1900–8.Google Scholar
  68. 68.
    Ruch DS, Ginn A, Yang CC, Smith BP, Rushing J, Hanel DP. Use of a distraction plate for distal radial fractures with metaphyseal and diaphyseal comminution. J Bone Joint Surg (Am). 2005;87A:945–54.CrossRefGoogle Scholar
  69. 69.
    May MM, Lawton JN, Blazar PE. Ulnar styloid fractures associated with distal radial fractures: incidence and implications for distal radioulnar joint instability. J Hand Surg (Am). 2002;27A:965–71.CrossRefGoogle Scholar
  70. 70.
    Solgaard S. Function after distal radius fracture. Acta Orthop Scand. 1988;59:39–42.PubMedCrossRefGoogle Scholar
  71. 71.
    Fernandez DL. Fractures of the distal radius: operative treatment. AAOS Instruct Course Lect. 1993;42:73–88.Google Scholar
  72. 72.
    Biyani A, Simison AJM, Klenerman L. Fractures of the distal radius and ulna. J Hand Surg (Br). 1995;20B:357–64.CrossRefGoogle Scholar
  73. 73.
    Noda K, Goto A, Murase T, Sugamoto K, Yoshikawa H, Moritomo H. Interosseous membrane of the forearm: an anatomical study of ligament attachment locations. J Hand Surg (Am). 2009;34A:415–42.CrossRefGoogle Scholar
  74. 74.
    Ring D, McCarty LP, Campbell DA, Jupiter JB. Condylar blade plate fixation of unstable fractures of the distal ulna associated with fracture of the distal radius. J Hand Surg (Am). 2004;29A:103–9.CrossRefGoogle Scholar
  75. 75.
    Dennison D. Open reduction and internal locked fixation of unstable distal ulna fractures with concomitant distal radius fracture. J Hand Surg (Am). 2007;32A:801–5.CrossRefGoogle Scholar
  76. 76.
    McKee MD, Waddell JP, Yoo D, Richards RR. Non union of distal radial fractures associated with distal ulnar shaft fractures: a report of four cases. J Orthop Trauma. 1997;11:49–53.PubMedCrossRefGoogle Scholar
  77. 77.
    Hauck RM, Hershey PA, Shahen J, Palmer AK. Classification and treatment of ulnar styloid non union. J Hand Surg (Am). 1996;21A:418–22.CrossRefGoogle Scholar
  78. 78.
    Richards RS, Bennett JD, Roth JH, Milne K. Arthroscopic diagnosis of intra-articular soft tissue injuries associated with distal radial fractures. J Hand Surg (Am). 1997;22A:772–6.CrossRefGoogle Scholar
  79. 79.
    Scheer JH, Adolfsson LE. Radioulnar laxity and clinical outcome do not correlate after a distal radius fracture. J Hand Surg (Eur). 2011;36E:503–8.CrossRefGoogle Scholar
  80. 80.
    Jupiter JB. Commentary: the effect of ulnar styloid fractures on patient-rated outcomes after volar locking plating of distal radius fractures. J Hand Surg (Am). 2009;34A:1603–4.CrossRefGoogle Scholar
  81. 81.
    Forward DP, Lindau TR, Melsom DS. Intercarpal ligament injuries associated with fractures of the distal part of the radius. J Bone Joint Surg (Am). 2007;89A:2334–40.CrossRefGoogle Scholar
  82. 82.
    Varitimidis SE, Basdekis GK, Dailliana ZH, Hantes ME, Bargiotas K, Malizos K. Treatment of intra-articular fractures of the distal radius: fluoroscopic or arthroscopic reduction? J Bone Joint Surg (Br). 2008;90B:778–85.CrossRefGoogle Scholar
  83. 83.
    Campbell DA. Letter to the editor. J Hand Surg (Eur). 2007;32E:233–4.CrossRefGoogle Scholar
  84. 84.
    Singer BR, McLauchlan GJ, Robinson CM, Christie J. Epidemiology of fractures in 15,000 adults: the influence of age and gender. J Bone Joint Surg (Br). 1998;80B:243–8.CrossRefGoogle Scholar
  85. 85.
    Nesbitt KS, Failla JM, Les C. Assessment of instability factors in adult distal radius fractures. J Hand Surg (Am). 2004;29A:1128–38.CrossRefGoogle Scholar
  86. 86.
    Beumer A, McQueen MM. Fractures of the distal radius in low-demand elderly patients: closed reduction of no value in 53 of 60 wrists. Acta Orthop Scand. 2003;74:98–100.PubMedCrossRefGoogle Scholar
  87. 87.
    Kennedy C, Kennedy MT, Niall D, Devitt A. Radiological outcomes of distal radius extra-articular fragility fractures treated with extra-focal kirschner wires. Injury. 2010;41:639–42.PubMedCrossRefGoogle Scholar
  88. 88.
    Jupiter JB, Ring D, Weitzel PP. Surgical treatment of redisplaced fractures of the distal radius in patients older than 60 years. J Hand Surg (Am). 2002;27A:714–23.CrossRefGoogle Scholar
  89. 89.
    Orbay JL, Fernandez DL. Volar fixed-angle plate fixation for unstable distal radial fractures in the elderly patient. J Hand Surg (Am). 2004;29A:96–102.CrossRefGoogle Scholar
  90. 90.
    Arora R, Lutz M, Fritz D, Zimmermann R, Oberladstätter J, Gabl M. Palmar locking plate for treatment of unstable dorsal dislocated distal radius fractures. Arch Orthop Trauma Surg. 2005;125(6):399–404.PubMedCrossRefGoogle Scholar
  91. 91.
    Chung KC, Squitieri L, Kim HM. Comparative outcomes study using the volar locking plating system for distal radius fractures in both young adults and adults older than 60 years. J Hand Surg (Am). 2008;33A:809–19.CrossRefGoogle Scholar
  92. 92.
    Walz M, Kolbow B, Auerbach F. Do fixed angle T-plates offer advantages for distal radius fractures in elderly patients? Unfallchirurg. 2004;107:664–70.PubMedGoogle Scholar
  93. 93.
    Roumen RM, Hesp WL, Bruggink ED. Unstable Colles fractures in elderly patients. A randomized trial of external fixation for redisplacement. J Bone Joint Surg (Br). 1991;73B:307–11.Google Scholar
  94. 94.
    Kelly AJ, Warwick D, Crichlow TP, Bannister GC. Is manipulation of moderately displaced Colles’ fracture worthwhile? A prospective randomized trial. Injury. 1997;28:283–7.PubMedCrossRefGoogle Scholar
  95. 95.
    Young BT, Rayan GM. Outcome following nonoperative treatment of displaced distal radius fractures in low-demand patients older than 60 years. J Hand Surg (Am). 2000;25A:19–28.CrossRefGoogle Scholar
  96. 96.
    Anzarut A, Johnson JA, Rowe BH, Lambert RG, Blitz S, Majumdar SR. Radiologic and patient-reported functional outcomes in an elderly cohort with conservatively treated distal radius fractures. J Hand Surg (Am). 2004;29A:1121–7.CrossRefGoogle Scholar
  97. 97.
    Azzopardi T, Ehrendorfer S, Coulton T, Abela M. Unstable extra-articular fractures of the distal radius: a prospective, randomized study of immobilization in a cast versus supplementary percutaneous pinning. J Bone Joint Surg (Br). 2005;87B:837–40.CrossRefGoogle Scholar
  98. 98.
    Hegeman JH, Oskam J, Vierhout PA, Ten Duis HJ. External fixation for unstable intra-articular distal radial fractures in women older than 55 years. Acceptable functional end results in the majority of the patients despite significant secondary displacement. Injury. 2005;36:339–44.PubMedCrossRefGoogle Scholar
  99. 99.
    Jaremko JL, Lambert RG, Rowe BH, Johnson JA, Majumdar SR. Do radiographic indices of distal radius fracture reduction predict outcomes in older adults receiving conservative treatment? Clin Radiol. 2007;62:65–72.PubMedCrossRefGoogle Scholar
  100. 100.
    McQueen MM, Caspers J. Colles fracture: does the anatomical result affect the final function? J Bone Joint Surg (Br). 1988;70B:649–51.Google Scholar

Copyright information

© Springer-Verlag London 2015

Authors and Affiliations

  1. 1.Department of Trauma & Orthopaedic SurgeryLeeds Teaching Hospitals NHS TrustLeedsUK
  2. 2.Department of Orthopaedic SurgeryTameside General HospitalAshton Under Lyne, LancashireUK

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