The relationship between radiographic and functional outcomes in older patients with distal radius fractures is controversial.
We explored this relationship by assessing the influence of radiographic displacement and fracture comminution on the functional
outcomes of these fractures. We also asked whether operative intervention and demographic factors (age, gender, duration of
followup) influenced outcome. We examined 53 patients older than 55 years with distal radius fractures with various functional
assessments: range of motion (ROM) and strength measurements, three subjective surveys (Disabilities of the Arm, Shoulder,
and Hand; Patient-rated Wrist Evaluation; Modernized Activity Subjective Survey of 2007), a Gartland and Werley score, and
an objective, standardized hand performance test (Jebsen-Taylor). We measured angulation, articular gap/stepoff, and radial
shortening on final radiographs and fracture comminution of preoperative radiographs. We observed no effect of radiographic
displacement on subjective or objective outcome assessments, including standardized hand performance timed testing. Surgically
treated fractures were less likely to display residual dorsal angulation and radial shortening, but surgical intervention
did not independently predict functional outcome. Fracture comminution, patient gender, and months of followup similarly had
no effect on outcome. We found no relationship between anatomic reduction as evidenced by radiographic outcomes and subjective
or objective functional outcomes in this older patient cohort.
Level of Evidence: Level II, diagnostic study. See the Guidelines for Authors for a complete description of levels of evidence.
Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest,
patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.
Each author certifies that his or her institution has approved the human protocol for this investigation, that all investigations
were conducted in conformity with ethical principles of research, and that informed consent for participation in the study
was obtained.