XXXX of the distal end of the radius in young adults.

@entity174 @entity2720 @entity625 @entity7334
@entity7334 of the distal part of the radius in young adults comprise a distinct subgroup of @entity174 that are difficult to manage and are associated with a high frequency of post-traumatic @entity625 . The effect of residual radiocarpal incongruity after this fracture has not been investigated previously. A retrospective study of forty-three @entity174 in forty young adults (mean age, 27.6 years) was done to determine the components that are critical to the outcome. Treatment included application of a cast alone in twenty-one @entity174 , insertion of pins and application of a plaster cast in seventeen, external fixation in two @entity174 , and open reduction and internal fixation in three @entity174 . At a mean follow-up of 6.7 years, 26 per cent were rated as excellent; 35 per cent, as good; 33 per cent, as fair; and 6 per cent, as poor. There was radiographic evidence of post-traumatic @entity625 in twenty-eight (65 per cent) of the @entity174 . Accurate articular restoration was the most critical factor in achieving a successful result. Of the twenty-four @entity174 that healed with residual incongruity of the radiocarpal joint, @entity625 was noted in 91 per cent, whereas of the nineteen @entity174 that healed with a @entity2720 , @entity625 developed in only 11 per cent. A depressed articular surface (a so-called die-punch fragment) was reduced anatomically by closed means in only 49 per cent and was responsible for residual incongruity in 75 per cent of the @entity2720 at late follow-up. Non-union of the ulnar styloid process adversely affected the results. Restoration and maintenance (extra-articular reduction) of the dorsal tilt and radial length did not prove critical except when severe radial shortening occurred.
