Influence of distal radius fractures involving the intermediate column on forearm rotation

J Orthop Surg Res. 2019 Apr 24;14(1):111. doi: 10.1186/s13018-019-1155-4.


Background: The objective of the study was to compare the radiologic and clinical outcome of patients with distal radius fractures involving the intermediate column and distal radial metaphyseal fractures treated conservatively.

Methods: Two cohorts of 52 matched patients with distal radius fractures treated conservatively, one with a fracture involving the intermediate column and the other with no intermediate column fracture, were retrospectively analyzed by examining the data. Patients were matched for age, sex, fracture side, and AO fracture type. The two groups were analyzed for differences in wrist motion; grip strength; Gartland and Werley score; Disabilities of the Arm, Shoulder and Hand (DASH) score; and visual analogue scale (VAS) score at 12 months. The differences in continuous variables were compared using the paired t test. Linear regression analyses or Pearson correlation analyses were used to evaluate the associations of radiological parameters with clinical outcomes.

Results: The analysis showed significant differences in the range of motion (ROM) for pronation (p = 0.000) and supination (p = 0.008) in the paired groups. There was a significant difference in DASH scores (p = 0.024) in the paired groups. Using Pearson correlation analysis, negative correlations (r = - 0.360, p = 0.000) were observed between articular step-off and ROM for pronation. Linear regression analyses also indicated that ROM for pronation had negative relationships (β = - 6.327, p = 0.001) with articular step-off.

Conclusions: Distal radius fractures involving the intermediate column had an adverse effect on forearm rotation after distal radius fractures treated conservatively.

Keywords: A three-column theory; Distal radius fracture; The intermediate column; Triangular fibrocartilage complex.

MeSH terms

  • Adult
  • Aged
  • Cohort Studies
  • Female
  • Forearm / diagnostic imaging*
  • Forearm / physiology*
  • Humans
  • Male
  • Middle Aged
  • Radius Fractures / diagnostic imaging*
  • Radius Fractures / physiopathology
  • Rotation*