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Assessment of Instability Factors in Adult Distal Radius Fractures – Nesbitt et al (J Hand Surg 2004)

PMID 15576227

  • Lafontaine factors of instability
    • initial dorsal angulation of greater than 20 degrees
    • dorsal comminution
    • radiocarpal intraarticular involvement
    • associated ulna fractures
    • age greater than 60
  • This study looked at 50 patients with radiographs at 1 week, 2 weeks, and 4 weeks after reduction
    • Age was found to be a statistically significant predictor of secondary displacement
    • Age was the only factor that mattered in multivariate analysis
    • 46% of the patients managed by closed reduction and sugar tong immobilization maintained adequate radiographic alignment
  • NOTE: Current AAOS recommendations (2011) recommend following nonoperative distal radius fractures with radiographs weekly for the first 3 weeks

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