The effect of dorsal cortical comminution on radiographic results of unstable distal radius fractures treated with closed reduction and K-wire fixation

Objectives: The purpose of this study was to evaluate the effect of dorsal cortical comminution on radiographic out-come of unstable distal radius fractures after treatment with closed reduction and K-wire fixation. Methods: Forty-two patients were treated with closed reduc¬tion and K-wire fixation for unstable, extra-articular distal radius fractures with dorsal angulation. The patients were evaluated in two groups depending on the presence or absence of dorsal metaphyseal cortical comminution observed as a radiopacity on lateral radiographs. Thus, 30 patients (13 males, 17 females; mean age 56 years; range 22 to 77 years) did not have dorsal cortical comminution, where¬as 12 patients (8 males, 4 females; mean age 48 years; range 18 to 76 years) did. The mean follow-up period was 8.8 months (range 3 to 106 months) in the former, and 5.5 months (range 3 to 131 months) in the latter groups. Radiographic parameters were compared including palmar tilt measured on lateral, radial inclination and radial length on posteroanterior radiographs obtained before treatment and after union. Results: Radial inclination, palmar tilt, and radial length showed significant improvements in both groups (p<0.05). The results were acceptable in all the patients with achievement of standard reference values. The pres¬ence of dorsal cortical comminution did not have any sig¬nificant effect on radiographic parameters (p>0.05). No significant complications were encountered during the follow-up period. Conclusion: Dorsal cortical metaphyseal comminution does not have an adverse effect on radiographic results. Treatment with closed reduction and K-wire fixation is safe and effec¬tive even in the presence of dorsal cortical comminution.