Conservative treatment of intra-articular fractures of the distal radius--factors affecting functional outcome.

One hundred and eleven intra-articular fractures of the distal radius in young adults that were conservatively treated were studied. At two years, 80% of fractures were rated as excellent or good by the modified Green and O'Brien scoring system. The rate of re-displacement within casts was 28%. Sixty five per cent of re-displaced fractures were treated with surgical fixation. Those re-displaced fractures treated with repeated manipulation had only 33% excellent or good result. Moreover, their initial alignment could not be preserved. Axial compression (>2 mm) and dorsal angulation (>15 degrees ) were directly related to worse functional outcome and diminished range of motion.