Determining the Borderline Anatomical Parameters for Better Functional Outcome of Colles Fracture: A Prospective Study

确定改善科雷氏骨折功能预后的临界解剖参数:一项前瞻性研究

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Abstract

Objective  The treatment of Colles fracture can deform the wrist. Some studies claim the resulting deformity rarely hinders daily activities, whereas others report the opposite; thus, anatomical reduction is desirable. Our objective was to analyze the anatomical and functional results of Colles fracture to find out the values of individual parameters corresponding to the best functional outcome. Methods  The present prospective study included 70 elderly patients with Colles fracture. All patients were managed conservatively. The anatomical parameters were evaluated by measuring dorsal angulation, radial inclination, and radial height, and they were assessed as per Stewart et al. The functional result was assessed by the Mayo wrist score. The results were analyzed using the chi-squared test of association, and a p -value < 0.001 was considered statistically significant and to examine strengths of associations; we computed odds ratios (ORs) with 95% confidence intervals (CI). Results  Excellent and good results were obtained in 68.5% of the cases anatomically and 78.5% functionally, which was statistically significant ( p  = 0.0009). Out of the three anatomical parameter dorsal angulation < 10° and loss of radial inclination < 9° showed statistically significant association with functional results ( p  = 0.0006), but loss of radial height < 6 mm did not ( p  = 0.0568), which became significant when loss of radial height was kept < 4 mm ( p  = 0.00062). Conclusion  Fractures with anatomical reduction have better functional results. The acceptable borderline anatomical parameters for obtaining excellent or good functional results are dorsal angulation < 10°, loss of radial inclination < 9°, and loss of radial height < 4 mm.

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