Comparative Assessment of Outcomes of Surgical Treatment of Smith and Colles Distal Radius Fractures.

BACKGROUND: The aim of the present study was to assess the effectiveness of surgical treatment of distal radial fractures following open reduction and fixation with an angle-stable plate in relation to the type of injury (flexion vs. extension fracture).

MATERIAL AND METHODS: A group of 25 patients with Colles fractures and 25 patients with Smith fractures treated surgically in the years 2012-2013 was analysed retrospectively. The results were evaluated using the quickDASH and Mayo Wrist Score. Radiographic follow-up assessments included radial inclination, radial height, volar tilt and articular step-off.

RESULTS: The mean Mayo Wrist Score was 72.8 points for Colles fractures and 68.3 points for Smith fractures. The mean quickDASH score was 18.2 points for Colles fractures and 20.5 points for Smith fractures. However, these differences were not statistically significant. The only significant difference in the radiographic parameters investigated was in volar tilt, which was normal in the group of patients with Smith fractures (11°), whereas in the group with Colles fractures it was 5°.

CONCLUSIONS: 1. In fractures of the distal radius, the type of displacement has no significant effect on the final outcome of surgical plate fixation. 2. In fractures with dorsal displacement of fragments, it is more difficult to restore volar tilt from a volar approach.