The value of manipulation of displaced distal radius fractures in the emergency department

The aim of this study was to report the success of maintaining reduced distal radius fractures with cast immobilisation and analyse risk factors for redisplacement. A retrospective analysis of distal radius fractures manipulated between April 2011 and 2013 was conducted. Age, gender, fracture classification, ulna fracture, dorsal comminution and volar alignment were recorded. Reduction and redisplacement were measured using Sarmiento's modification of Lidstrom's system. 110 patients were included: mean age 62.8 years and 833.4% female. The initial fracture was classified at A1 (1%), A2 (44%), A3 (25%), C1 (20%) and C2 (10%). 86.4% of cases were improved following manipulation, although 48.4% redisplaced and 27.4% required surgical intervention. The radial length (60%) was harder to maintain than dorsal alignment (44%). Successful alignment of the volar cortices was associated with a statistically signficant reduction in redisplacement (p=0.024). Manipulation of distal radius fractures is initially beneficial but half of cases redisplace