RESULTS AFTER THERAPY OF FRACTURES OF THE DISTAL RADIUS BY OPERATION

Fractures of the distal radius are being surgically treated with incre asing frequency, because of the poor results yielded by cast treatment . Using the AO fracture classification as a basis, we present a treatm ent regimen for the these fractures. For surgical interventions we pre fer closed reduction and osteosynthesis with, for ex percutaneus K-wir e fixation, intrafocal (Kapandji) pinning, minimal open screw osteosyn thesis, fixateur externe and combined methods; only fractures of type B2 and B3 will be treated by open reduction and application of an inte rnal plate. In addition, we present the results of a follow-up examina tion in 100 patients (85 female, 15 male) with radius fractures treate d operatively: their average age was 59 years (range 18 - 91) and the average follow-up period was 21 months (range 12 - 36). According to t he AO classification we found mostly fractures were of type A3.2 (n = 40) and type C2.2 (n = 23). We selected the method of osteosynthesis i n dependence on the AO classification. The functional result was judge d according to Sarmiento's modification of the Gartland and Werley sco re. The overall results were excellent or good in 80% of the patients, only 7% had a moderate result; none of the patients had a poor result . The radiological result was measured by the Lidstrom score: 97%, gra de I and II; only 2%, grade III; 1% grade IV. Our results have shown t hat anatomical reduction of the fracture is essential if a good functi onal result is to be obtained.