Functional and radiological outcome of Colles fracture treated conservatively with plaster and cast
DOI:
https://doi.org/10.3126/jmcjms.v7i1.30006Keywords:
Cast, Colles Fracture, Functional and Radiological outcomeAbstract
Background and Objectives: Fractures of distal radius are commonly encountered in orthopedic emergency. Various treatment methods are available including closed reduction and immobilization in cast, percutaneous pinning, pins and plaster, external fixation, open reduction and internal fixation with or without bone graft or substitute. There are no clear guidelines to follow. The aim of this study is to compare the radiological and functional outcome of distal radius fracture treated conservatively with cast alone.
Material and Methods: Sixty patients suffering from extra articular distal radius fracture were recruited for study. They were all treated conservatively with cast alone. They were followed up for 6 months. The radiological outcome in terms of dorsal angulation, radial length, radial angulation and ulnar variance and functional outcome in terms of Mayo wrist score was assessed.
Results: At 6 months follow up dorsal angulation, radial length, radial angulation and ulnar variance were - 5±3.20 degrees, 7.80±0.77mm, 20.47±2.29 degrees and 1.27±0.77 respectively. Functionally 20 patients had good outcome, 32 patients had satisfactory outcome and 8 patients had poor outcome in terms of Mayo wrist scores.
Conclusion: Conservative management with cast is an effective treatment modality for Frykmans type I and II Colles fracture with satisfactory functional and radiological outcome.
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References
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https://doi.org/10.1056/NEJM181410010030410
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3. Miyake T, Hashizume H, Inoue H, Shi Q, Nagayama N. Malunited Colles' fracture. Analysis of stress distribution. Journal of hand surgery (Edinburgh, Scotland). 1994 Dec;19(6):737-42. PubMed PMID: 7706877. Epub 1994/12/01. eng.
https://doi.org/10.1016/0266-7681(94)90248-8
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https://doi.org/10.2106/00004623-195133040-00009
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https://doi.org/10.1016/j.injury.2005.09.005
6. Sivaprakash SU, Reddy RM. Functional outcome of comminuted intra-articular distal radius fractures managed by Ligamentotaxis. Int J Orthop Sci. 2019;5:75-9.
https://doi.org/10.22271/ortho.2019.v5.i1b.17
7. Somesula JB, Venkata Naga MRP. A prospective study of surgical management of distal radius fracture in adult with plate fixation. Int J Orthop Sci. 2017;3:236-40.
https://doi.org/10.22271/ortho.2017.v3.i3d.47a
8. Bagul R, Yadav K, Rai A, Deo S, Patole V. Comparative study of functional outcome i
9. Colles' fracture treated conservatively by closed reduction and cast and closed reduction, Kirschner wire and cast. J Pharm Biomed Sci. 2016;6:464-8.
10. 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;29:1121-7.
https://doi.org/10.1016/j.jhsa.2004.07.002
11. 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
12. reduction, percutaneous fixation, and external fixation. J Hand Surg Am. 2005;30:764-72.
https://doi.org/10.1016/j.jhsa.2005.04.019
13. TJ G. surgical correction of malunited fractures of distal radius. J Am Acad Orthop Surg. 1997;5:270.
https://doi.org/10.5435/00124635-199709000-00005
14. van der Linden W, Ericson R. Colles' fracture. How should its displacement be measured and how should it be immobilized? The Journal of bone and joint surgery American volume. 1981 Oct;63(8):1285-8. PubMed PMID: 7287798. Epub 1981/10/01. eng.
https://doi.org/10.2106/00004623-198163080-00009
15. Cooney WP, Bussey R, Dobyns JH, Linscheid RL. Difficult wrist fractures. Perilunate fracture-dislocations of the wrist. Clinical orthopaedics and related research. 1987 Jan(214):136- 47. PubMed PMID: 3791735. Epub 1987/01/01. eng.
https://doi.org/10.1097/00003086-198701000-00020
16. Jupiter JB. Fractures of the distal end of the radius. The Journal of Bone & Joint Surgery. 1991 1991-03-01 00:00:00;73(3):461-9.
https://doi.org/10.2106/00004623-199173030-00019
17. 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;29:1121-7.
https://doi.org/10.1016/j.jhsa.2004.07.002
18. Cooney WP, 3rd, Dobyns JH, Linscheid RL. Complications of Colles' fractures. The Journal of bone and joint surgery American volume. 1980;62(4):613-9. PubMed PMID: 6155380. Epub 1980/01/01. eng..
https://doi.org/10.2106/00004623-198062040-00016
19. Porter M, Stockley I. Fractures of the distal radius. Intermediate and end results in relation to radiologic parameters. Clinical orthopaedics and related research. 1987 Jul(220):241- 52. PubMed PMID: 3594997. Epub 1987/07/01. eng
https://doi.org/10.1097/00003086-198707000-00034
20. Kumar K, Laghari MA, Bhutto IA, Lal K. Fracture of Distal Radius Treated by Orthofix v/s Plaster Cast. J Liaquat Uni Med Health Sci. 2014;13:120-4.
21. Roumen RM, Hesp WL, Bruggink ED. Unstable Colles fractures in elderly patients. A randomised trial of external fixator for redisplacement. J Bone Joint Surg Br 1991;73:307-11.
https://doi.org/10.1302/0301-620X.73B2.2005162
22. Grle M , Miljko M , Grle I , Hodžiæ F , Kapidžiæ T. Early results of the conservative treatment of distal radius fractures immobilization of the wrist in dorsal versus palmar flexion. Med Glas(Zenica).2017;14:236-43.
23. Arora J, Kapoor H, Malik A, Bansal M. Closed reduction and plaster cast, immobilization Vs. external fixation in comminuted intra-articular fractures of distal radius. Indian J Orthop. 2004;38:113-7.
24. Song J, Yu AX and Li ZH. Comparison of conservative and operative treatment for distal radius fracture: a meta-analysis of randomized controlled trials. Int J Clin Exp Med. 2015;8:17023-3
25. Young BT, Rayan GM. Outcome following non operative treatment of displaced distal radius fractures in low demand patients older than 60 years. J Hand Surg 2000;25-A:19-28
https://doi.org/10.1053/jhsu.2000.jhsu025a0019
26. MO P. From American academy of orthopaedics, annual meeting. Advances in distal radius fractures management. published in net by orthoteers: 1999.
27. Young BT, Rayan GM. Outcome following nonoperative treatment of displaced distal radius fractures in low-demand patients older than 60 years. The Journal of hand surgery. 2000 Jan;25(1):19-28. PubMed PMID: 10642469. Epub 2000/01/22. eng.
https://doi.org/10.1053/jhsu.2000.jhsu025a0019
28. Veldman PH, Reynen HM, Arntz IE, Goris RJ. Signs and symptoms of reflex sympathetic dystrophy: prospective study of 829 patients. Lancet (London, England). 1993 Oct 23;342(8878):1012-6. PubMed PMID: 8105263. Epub 1993/10/23. eng.
https://doi.org/10.1016/0140-6736(93)92877-V
https://doi.org/10.1056/NEJM181410010030410
2. Simic PM, Weiland AJ. Fractures of the distal aspect of the radius: changes in treatment over the past two decades. Instructional course lectures. 2003;52:185-95. PubMed PMID: 12690848. Epub 2003/04/15. eng.
3. Miyake T, Hashizume H, Inoue H, Shi Q, Nagayama N. Malunited Colles' fracture. Analysis of stress distribution. Journal of hand surgery (Edinburgh, Scotland). 1994 Dec;19(6):737-42. PubMed PMID: 7706877. Epub 1994/12/01. eng.
https://doi.org/10.1016/0266-7681(94)90248-8
4. Gartland JJ, Jr., Werley CW. Evaluation of healed Colles' fractures. The Journal of bone and joint surgery American volume. 1951 Oct;33- A(4):895-907. PubMed PMID: 14880544. Epub 1951/10/01. eng.
https://doi.org/10.2106/00004623-195133040-00009
5. Karnezis IA, Panagiotopoulos E, Tyllianakis M, Megas P, Lambiris E. Correlation between radiological parameters and patient-rated wrist dysfunction following fractures of the distal radius. Injury. 2005 Dec;36(12):1435-9. PubMed PMID: 16256994. Epub 2005/11/01. eng.
https://doi.org/10.1016/j.injury.2005.09.005
6. Sivaprakash SU, Reddy RM. Functional outcome of comminuted intra-articular distal radius fractures managed by Ligamentotaxis. Int J Orthop Sci. 2019;5:75-9.
https://doi.org/10.22271/ortho.2019.v5.i1b.17
7. Somesula JB, Venkata Naga MRP. A prospective study of surgical management of distal radius fracture in adult with plate fixation. Int J Orthop Sci. 2017;3:236-40.
https://doi.org/10.22271/ortho.2017.v3.i3d.47a
8. Bagul R, Yadav K, Rai A, Deo S, Patole V. Comparative study of functional outcome i
9. Colles' fracture treated conservatively by closed reduction and cast and closed reduction, Kirschner wire and cast. J Pharm Biomed Sci. 2016;6:464-8.
10. 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;29:1121-7.
https://doi.org/10.1016/j.jhsa.2004.07.002
11. 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
12. reduction, percutaneous fixation, and external fixation. J Hand Surg Am. 2005;30:764-72.
https://doi.org/10.1016/j.jhsa.2005.04.019
13. TJ G. surgical correction of malunited fractures of distal radius. J Am Acad Orthop Surg. 1997;5:270.
https://doi.org/10.5435/00124635-199709000-00005
14. van der Linden W, Ericson R. Colles' fracture. How should its displacement be measured and how should it be immobilized? The Journal of bone and joint surgery American volume. 1981 Oct;63(8):1285-8. PubMed PMID: 7287798. Epub 1981/10/01. eng.
https://doi.org/10.2106/00004623-198163080-00009
15. Cooney WP, Bussey R, Dobyns JH, Linscheid RL. Difficult wrist fractures. Perilunate fracture-dislocations of the wrist. Clinical orthopaedics and related research. 1987 Jan(214):136- 47. PubMed PMID: 3791735. Epub 1987/01/01. eng.
https://doi.org/10.1097/00003086-198701000-00020
16. Jupiter JB. Fractures of the distal end of the radius. The Journal of Bone & Joint Surgery. 1991 1991-03-01 00:00:00;73(3):461-9.
https://doi.org/10.2106/00004623-199173030-00019
17. 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;29:1121-7.
https://doi.org/10.1016/j.jhsa.2004.07.002
18. Cooney WP, 3rd, Dobyns JH, Linscheid RL. Complications of Colles' fractures. The Journal of bone and joint surgery American volume. 1980;62(4):613-9. PubMed PMID: 6155380. Epub 1980/01/01. eng..
https://doi.org/10.2106/00004623-198062040-00016
19. Porter M, Stockley I. Fractures of the distal radius. Intermediate and end results in relation to radiologic parameters. Clinical orthopaedics and related research. 1987 Jul(220):241- 52. PubMed PMID: 3594997. Epub 1987/07/01. eng
https://doi.org/10.1097/00003086-198707000-00034
20. Kumar K, Laghari MA, Bhutto IA, Lal K. Fracture of Distal Radius Treated by Orthofix v/s Plaster Cast. J Liaquat Uni Med Health Sci. 2014;13:120-4.
21. Roumen RM, Hesp WL, Bruggink ED. Unstable Colles fractures in elderly patients. A randomised trial of external fixator for redisplacement. J Bone Joint Surg Br 1991;73:307-11.
https://doi.org/10.1302/0301-620X.73B2.2005162
22. Grle M , Miljko M , Grle I , Hodžiæ F , Kapidžiæ T. Early results of the conservative treatment of distal radius fractures immobilization of the wrist in dorsal versus palmar flexion. Med Glas(Zenica).2017;14:236-43.
23. Arora J, Kapoor H, Malik A, Bansal M. Closed reduction and plaster cast, immobilization Vs. external fixation in comminuted intra-articular fractures of distal radius. Indian J Orthop. 2004;38:113-7.
24. Song J, Yu AX and Li ZH. Comparison of conservative and operative treatment for distal radius fracture: a meta-analysis of randomized controlled trials. Int J Clin Exp Med. 2015;8:17023-3
25. Young BT, Rayan GM. Outcome following non operative treatment of displaced distal radius fractures in low demand patients older than 60 years. J Hand Surg 2000;25-A:19-28
https://doi.org/10.1053/jhsu.2000.jhsu025a0019
26. MO P. From American academy of orthopaedics, annual meeting. Advances in distal radius fractures management. published in net by orthoteers: 1999.
27. Young BT, Rayan GM. Outcome following nonoperative treatment of displaced distal radius fractures in low-demand patients older than 60 years. The Journal of hand surgery. 2000 Jan;25(1):19-28. PubMed PMID: 10642469. Epub 2000/01/22. eng.
https://doi.org/10.1053/jhsu.2000.jhsu025a0019
28. Veldman PH, Reynen HM, Arntz IE, Goris RJ. Signs and symptoms of reflex sympathetic dystrophy: prospective study of 829 patients. Lancet (London, England). 1993 Oct 23;342(8878):1012-6. PubMed PMID: 8105263. Epub 1993/10/23. eng.
https://doi.org/10.1016/0140-6736(93)92877-V
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Published
2019-12-31
How to Cite
Sharma, S., Sharma, R., Neupane, S., Pariyar, A., & Singh, R. (2019). Functional and radiological outcome of Colles fracture treated conservatively with plaster and cast. Janaki Medical College Journal of Medical Science, 7(1), 47–52. https://doi.org/10.3126/jmcjms.v7i1.30006
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