A comparison of the long-term outcome of partial articular (AO Type B) and complete articular (AO Type C) distal radius fractures.

PURPOSE: A short-term comparison of AO type B (shearing) and type C (compression) articular fractures of the distal radius found no significant differences in functional outcome, but long-term studies would provide important information. We tested the null hypothesis that there is no difference in arm-specific disability between patients with type B and C fractures in long-term follow-up. METHODS: We evaluated 46 patients (17 with type B fractures and 29 patients with 31 type C fractures of the distal radius) with a mean age of 39 years at the time of injury at a mean of 20 years after operative treatment. We used the Disabilities of the Arm, Shoulder, and Hand questionnaire and 2 physician-based rating systems, the modified Mayo wrist score and the modified Gartland and Werley score. We performed bivariate and multivariable analyses to identify the factors that contributed most to the variation in these scores. RESULTS: There were no significant differences between patients with type B and C fractures on the Disabilities of the Arm, Shoulder, and Hand, modified Mayo wrist, or Gartland and Werley scores, or with respect to range of motion, grip strength, and arthrosis. The only statistical difference was in volar tilt of the articular surface on lateral radiographs. CONCLUSIONS: On average, patients undergoing operative treatment of type B and type C articular fractures of the distal radius have similar impairment, symptoms, and disability in the long-term. TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic III.

Quantitative 3-dimensional computed tomography measurement of distal humerus fractures.

PURPOSE: To measure the average number, size, shape and articular surface area of articular fracture fragments of the distal humerus using quantitative analysis of 3-dimensional computed tomography (3DCT) images. MATERIALS AND METHODS: Forty-eight computed tomography scans of distal humerus fractures were analyzed with quantitative 3DCT (Q3DCT). Twenty-one patients had a capitellum and trochlea fracture, and 27 patients had bicolumnar fractures of the distal humerus. The volume and articular surface area of each articular fracture fragment were measured. A small fragment was defined of having a volume of less than 500 mm(3) or an articular surface of less than 500 mm(2). RESULTS: Bicolumnar fractures have a mean of 9.3 fragments, 5.4 small fragments, and 3.7 articular fragments per fracture. Trochlea and capitellum fractures have a mean of 3.6 fragments, 1.5 small fragments, and 2.3 articular fragments per fracture. For each fracture type, the number of small fragments correlated with the total number of fragments. CONCLUSION: Columnar fractures had more articular fragments and more small fragments than trochlea and capitellum fractures.