Distal radius fracture natural history, complications and prognosis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Rohan A. Bhimani, M.B.B.S., D.N.B., M.Ch.[2]
Overview
If left untreated, majority of patients with distal radius fracture may progress to develop malunion and loss of range of motion of the wrist and forearm. Common complications of distal radius fracture include upper extremity stiffness, malunion, carpal tunnel syndrome or median nerve involvement, and radiocarpal arthritis. Prognosis is generally good, with most patients can resume their previous level of activity, including competitive sports.
Natural History, Complications, and Prognosis
Natural History
- If left untreated, majority of patients with distal radius fracture may progress to develop malunion and loss of range of motion of the wrist and forearm.[1][2]
Complications
- Common complications of distal radius fracture include:[3][4][5][6][7][8]
- Upper extremity stiffness
- Carpal tunnel syndrome or median nerve involvement
- Malunion
- Injury to the radial artery
- Carpal instability
- Distal Radio-Ulnar Joint (DRUJ) dysfunction
- Dupuytren's disease
- Radiocarpal arthritis
- Tendon injuries
- Ligament injuries
- Post-traumatic osteoarthritis
- Compartment syndrome
- Infection mostly by open fractures or after fracture fixation
- Complex regional pain syndrome
Prognosis
- Prognosis is generally good, with most patients can resume their previous level of activity, including competitive sports.[9][10]
- Most patients will likely lose a few degrees of final flexion and extension, and possibly supination as well; however, these limitations generally do not prevent full function.
- Some patients are unable to resume their prior level of functioning.
- All treatment approaches have a percentage of poor results, with decreased supination, prominent ulnar heads, ligamentous problems, distal radioulnar instability, and degenerative joint disease.
References
- ↑ Azar, F., Canale, S., Beaty, J. & Campbell, W. (2017). Campbell's operative orthopaedics. Philadelphia, PA: Elsevier. Page: 1898-2028.
- ↑ Handoll HHG, Madhok R. Conservative interventions for treating distal radial fractures in adults (Review). The Cochrane Library. 2008;4:1-112.
- ↑ Henry MH (2008). "Distal radius fractures: current concepts". J Hand Surg Am. 33 (7): 1215–27. doi:10.1016/j.jhsa.2008.07.013. PMID 18762124.
- ↑ van Aaken J, Beaulieu JY, Della Santa D, Kibbel O, Fusetti C (2008). "High rate of complications associated with extrafocal kirschner wire pinning for distal radius fractures". Chir Main. 27 (4): 160–6. doi:10.1016/j.main.2008.05.005. PMID 18678519.
- ↑ Turner RG, Faber KJ, Athwal GS (2010). "Complications of distal radius fractures". Hand Clin. 26 (1): 85–96. doi:10.1016/j.hcl.2009.08.005. PMID 20006247.
- ↑ Shin EK, Jupiter JB (2007). "Current concepts in the management of distal radius fractures". Acta Chir Orthop Traumatol Cech. 74 (4): 233–46. PMID 17877939.
- ↑ Egol, Kenneth (2010). Handbook of fractures. Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins Health. ISBN 9781605477602.
- ↑ Handoll HHG, Madhok R. Conservative interventions for treating distal radial fractures in adults (Review). The Cochrane Library. 2008;4:1-112.
- ↑ Kleinman WB (2010). "Distal radius instability and stiffness: common complications of distal radius fractures". Hand Clin. 26 (2): 245–64. doi:10.1016/j.hcl.2010.01.004. PMID 20494751.
- ↑ Azar, F., Canale, S., Beaty, J. & Campbell, W. (2017). Campbell's operative orthopaedics. Philadelphia, PA: Elsevier. Page: 1898-2028.