Aims: To investigate the correlation between radiological parameters of distal radial fractures and the clinical outcome expressed by objective clinical parameters and the level of patient-rated wrist dysfunction.

Methods: A Prospective study of 30 consecutive patients with unstable fractures of the distal radius treated with closed reduction and percutaneous wire fixation followed by six-week cast immobilisation and fully assessed for a period of one year. The outcome parameters included the fracture type, radial shortening, palmar angle, radial angle, presence of postoperative intra-articular ‘step-off’, range of wrist movement, grip strength, function and pain Patient-Rated Wrist Evaluation (PRWE) scores[1].

Results: There was statistically significant differences in the range of final wrist palmarflexion according to the AO fracture type (p=0.04, Kruskal-Wallis non-parametric analysis) and final wrist dorsiflexion and PRWE function score (p< 0.01 and p=0.02 respectively, Mann-Whitney test) according to the presence or not of postoperative articular ‘step-off’. Permanent radial shortening and loss of palmar angle correlated inversely with the PRWE pain score (p< 0.01 and p=0.03 respectively with statistical correlation).

Conclusions: Permanent radial shortening and loss of palmar angle are associated with prolonged wrist pain. Residual articular incongruity correlates with persisting loss of wrist dorsiflexion and wrist dysfunction a finding that contradicts the notion that loss of articular congruity is associated with late development of articular degeneration but not with early wrist dysfunction. The study failed to show any association between the fracture type and the functional outcome as rated by the patients.