Is the preoperative closed reduction irreplaceable for distal radius fracture surgical treatment? - A retrospective clinical study

Patients for all classifications of fresh distal radius fracture (DRF) routinely receive closed reduction combined with plaster immobilization at first. However, among these, some patients with serious communicated fractures asked for being treated surgically directly without prior closed reduction in clinical practice. Currently, the potential effect of preoperative closed reduction on therapeutic effects of surgical treatment has remained unclear. The purpose of the retrospective clinical study was to identify the potential effect of the preoperative closed reduction on therapeutic effects of surgical treatment for fresh (DRF). 128 patients with DRF were divided into two groups, with 70 patients receiving closed reduction combined with plaster immobilization before operation, and the other 58 patients being treated only with plaster or brace immobilization for temporary external fixation. These two groups of DRF cases were compared in operative time, postoperative functional examination results (wrist pain, the range of wrist motion, grip strength and wrist function questionnaire) and radiograph examination results (dorsal radial tilt, radial inclination, radial shortening and articular step off) at different time points as well as the final radiograph examination at 12 months. There were no differences in the demographic characteristics or fracture severity between groups. No significant difference was found between the two groups in the operation time and the rate of complications, but from the means, Closed reduction group (65 +/- 7.6) were shorter than the no closed reduction group (77 +/- 5.7). There was no significant difference between the two groups for the pain level, the mean ranges of motion, grip strength and DASH score at all time points. The two groups' dorsal radial tilt, radial inclination, radial shortening and articular step off also had no significance at the time of the last follow-up. Preoperative closed reduction and plaster immobilization techniques did not convey improvement of surgical results for the fresh fractures of the distal radius with volar palmar plates. But operation may cost the patients less time in the closed reduction and plaster immobilization group.