Title: The Risk Factors in the Displacement of Distal Radius Fractures Treated with Casting at De La Salle University Medical Center from May to August 2012
Objective: To determine the factors that contribute to displacement of distal radius fractures treated conservatively with casting at DLSU Medical Center
Study Design: The design is a prospective cohort analytical study conducted among patients at the DLSU Medical Center ER and OPD Departments during May to August 2012
Summary of Background Data: Distal radial fractures are still one of the most common upper extremity injury encountered by orthopedic surgeons. Despite the high prevalence of this type of injury, there is still no recommendation on the treatment of these fractures. Conservative methods still play a major role in treatment. Yet, factors affecting the risk of displacement after cast treatment remain a matter of debate, hence, the need for further studies.
Methods: Patients who were initially seen during the months of May to August 2012 and treated with a long arm cast in either the emergency department or the out-patient department of De La Salle University Medical Center were included. The patients were followed-up at 1week, at 4th week and prior to removal of cast with radiographs, and the amounts of angulation or translation as well as the quality of the cast were noted.
Results: A total of 77 subjects completed the entire study period. 11 variables were assessed; namely, age, gender, handedness, laterality of injury, AO Fracture Classification, Nature/Mechanism of Injury, Radiographic Parameters (Radial Height, Radial Tilt, Radial Inclination), Cast Index and Three Point Index. From these, only four factors were noted to be statistically significant. They were age, gender, radial height and radial tilt at time of injury. Then these variables were included in the multivariate regression analysis of this study and the remaining variable that was noted to be statistically significant was age.
Conclusion: The study succeeded in identifying the factors that are prognostic for the displacement for distal radial fractures; namely gender, radial tilt and radial height at time of injury and more importantly, the age. Hopefully with this study, we could properly predict those who would benefit best from casting or those patients who will most probably need operative treatment in the future.