Predicting Stability of Distally Displaced Radius Fractures after Closed Reduction in Adults Aged 18 to 65

What this Trial Is About

Researchers are studying radiological criteria to determine if dorsally displaced distal radius fractures can remain stable without surgery after closed reduction in patients aged 18 to 65 years. This study focuses on improving decision-making for surgery by identifying which fractures maintain their position after treatment with casting, considering factors such as osteoporosis and fracture types. The trial aims to reduce unnecessary surgeries that can cause complications and stress for patients while also addressing socio-economic concerns related to overtreatment. Participants with dorsally displaced distal radius fractures will undergo closed reduction and casting. X-rays will be taken before and after reduction, along with CT scans the day after reduction. Follow-up X-rays will be conducted at 6-8 days, with additional checks if slight redislocation occurs, and final X-rays will be performed after 3 months. The study will evaluate various radiological factors, including dorsal dislocation, ulnar variance, volar cortex positioning, and comminution, to determine fracture stability. Participants will have several visits for imaging and assessment of fracture position over 3 months. Experienced doctors will review X-rays and CT scans to measure fracture stability and decide if surgery is needed. The study will also record complications like complex regional pain syndrome and malunion surgeries. The primary outcome is radiological criteria at 3 months, with secondary outcomes including CT criteria and the influence of osteoporosis in patients aged 50-65. Total participation lasts about 3 months with periodic follow-up visits.

Radiological Criteria for Instability in Distal Radius Fractures