15 year follow-up after distal radius fracture. A pilot study on the relation between anatomical position and radiological osteoarthritis

Distal radius fractures (DRF) are common in emergency rooms and the incidence
of DRFs is expected to increase with the ageing of the population and the
increased life expectancy. However there is still much controversy in the
treatment of DRFs. Since the development of volar plating with fixed angle
screws the tendency to perform surgery as a primary treatment has increased
when a DRF is dislocated. It is generally thought that restoring the anatomical
position will lead to less osteoarthritis (OA). A retrospective study is
planned to study the relation between (the degree of) radiological OA and
achieving an anatomical position.

The primary outcome of this pilot study is the degree of OA that patients
develop after a DRF. The secondary objective is to measure the functional
outcome after treatment.

This is a retrospective pilot study, with a follow-up of 15 years. All patients
diagnosed with DRF between 1996 and 1998, who were between the age of 50-70
years, will be included. Initial treatment and X-ray will be reassessed. The
patients with an anatomical position of their wrist fracture will be in group
1. The second group will consist of all the other patients who did not have an
anatomical position.
Group 2 will be subdivided. Group 2a will consist of all the patients who, with
the current standard of treatment, would be operated. Group 2b will consist of
patients who with the current guidelines would have received the same
conservative treatment.

The patients will have to come to the hospital once for the questionnaire, four
X-rays of their wrists and a physical examination of the wrists. The dosage of
radiation exposure is approximately 4 x 0.001 mSv which is a negligible dosage.
In contrast: the yearly exposure to radiation from natural sources is about 2
mSv. The radiation exposure due to the wrist X-rays represents about 1/500 of a
normal yearly exposure.