A Retrospective Study of Non-operative Management of Distal Radial Fractures in an Indigenous Black Population

Background: Operative fixation is increasingly used to treat distal radial fractures. However, non-operative management of these fractures is common, especially in developing countries. Although surgery results in better restoration of anatomy, it is unclear if this translates to a better function.

Aim: The study aims to assess patients' functional outcome after non-operative treatment of distal radius fractures.

Methods: This work was a five-year retrospective study involving 35 subjects treated for a distal radial fracture with non-operative methods. The pre-operative and post-operative distal radius radiographic parameters, DASH scores at 22-month follow-up and the Frykman class of the fractures were documented. The correlation between the Frykman classes and DASH scores and that between the post-operative radiographic parameters and DASH scores was assessed.

Results: All the distal radius parameters except the palmar tilt improved with non-operative treatment in this study. There were no significant differences in the mean DASH scores between those with acceptable and non-acceptable radiographic indices. The most frequent class of fracture in this study was Frykman class 1. The Frykman class showed a strong correlation with the DASH score, with an increasing class of injury having a higher DASH score, rho= .651, p-value = .001.

Conclusion: Non-operative management of distal radial fractures was associated with favourable DASH scores, even though most of the patients had at least one unacceptable radiographic parameter post-reduction.