10 to 15 year follow-up after distal radius fracture. A retrsospective study on the relation between anatmical 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). However, it is not complete clear if this is
right.Through this retrospective study the relation between (the degree of)
radiological OA and achieving an anatomical position will be studied.

The primary objectives are to assess the degree of OA that patients develop 10
to15 year after a DRF, find out whether there is there is a difference in
degree of osteoarthritis between conservative treated patients with and without
an indication for surgery nowadays of the non-anatomical position of their
distal radius fracture and compare the degree of OA between the fractured and
contralateral wrist
Our secondary objective is to measure the functional outcome after treatment,
assess the prevalence of OA in our cohort, study the difference in degree of OA
between patients with the same non-anatomical position but different treatment
(operative versus conservative) and assess the prevalence of SLD in our cohort.

This retrospective pilot study, with a follow-up of 10 to 15 years, is a
continuation of a pilot study. All patients diagnosed with DRF between 2001 and
2005, who were between the age of 50-70 years at that time, 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 then be subdivided in three groups. Group 2a will consist of
patients who, under the current guidelines would have received the same
conservative treatment. Group 2b will consist of patients who would be operated
under the current guidelines but were nevertheless treated conservative at the
time of trauma. Group 2c will consist of patients who would be operated under
the current guidelines and were also operated at that time
To study the difference between OA of the fractured and contralateral wrist,
the non-fractured wrist of all patients will be assessed as well.

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.