The relationship between initial closed reduction and the surgical reconstruction of the radiocarpal joint line in distal radial fractures

IntroductionWhilst initial closed reduction followed by definitive open fixation is widely applied in the treatment of distal radial fractures, the effect of the closed reduction on the reconstruction of the articular surface remains unclear. Our research questions were:(1)Does closed reduction followed by surgical fixation reconstruct palmar tilt and radial inclination?(2)Does closed reduction influence the surgically reconstructed palmar tilt and radial inclination?MethodsPalmar tilt and radiocarpal inclination of 425 patients were measured at admission, following initial closed reduction and after surgical reconstruction.ResultsClosed reduction increased palmar tilt by 12.1° and radial inclination by 2.7°. Open surgical reduction further corrected palmar tilt by 17.88° and radial inclination by 3.5°. Whilst there was no association between postoperative palmar tilt and initially achieved closed reduction, a significant association between radial inclination following closed reduction and surgical fixation was found.ConclusionOur retrospective study challenges the existence of a relationship between the initial closed reduction and the reconstruction of the anatomic joint line in surgically treated distal radial fractures.