Correlation between functional and radiological assessment after treated distal radius fractures

Distal radius fractures (DRFs) are among the commonest fractures encountered by orthopaedic surgeons. Primary goal in the treatment of DRFs is to restore articular congruity. Evidence is inconsistent about the correlation of anatomic reduction results with improved wrist function. The functional outcomes are multifactorial. Hence, we aimed to study the correlation of radiological findings with functional outcomes and identify the patterns across treatment modalities and fracture types. Sixty adult patients with treated DRFs were included with minimum six months follow-up. AO classification was used for fracture classification. Patients were divided into three groups of 20 each based on treatment methods, namely cast, external fixation and plating. Radiological evaluation was done using Sarmiento et al.’s modification of Lidstrom's scoring system while functional assessment was done using Modified Mayo scoring system. Pearson's correlation and simple linear regression was done to identify the predictive ability of radiological scores on functional outcomes. Analysis of Variance (ANOVA) was used to compare the age, follow-up duration, radiological and functional scores across fracture types and treatment methods. Majority patients achieved excellent or good radiological and functional outcomes. There was no statistically significant difference in age, follow-up duration or functional scores between fracture types and treatment groups. Radiological scores were not significantly different between fracture types, but were significantly different in treatment groups, with external fixation having worse outcomes compared to cast and plating. A strong inverse Pearson's correlation (−0.743) was found between radiological and functional outcome (p < 0.001). Simple linear regression model was also statistically significant (p < 0.001) and R square was 0.552. Majority patients with DRFs have excellent or good radiological and functional outcomes. Plate fixation yields better anatomical restoration and early mobilization. There is strong radiological correlation with functional outcomes.