Objective: To determine how often arthrosis develops after a distal radius injury and whether it causes significant clinical problems. Introduction: Arthrosis is a non-inflammatory chronic joint disease that can result in serious clinical problems. Most of the arthroses develop on a traumatic basis; idiopathic causes are rare. Radiocarpal arthrosis is manifested by pain in motion, limitation of the range of motion, and reduced handgrip strength. Material and methodology: Patients with a follow-up period of at least 10 years after intraarticular fracture of distal radius were included in the retrospective study. Patients with type C fractures according to AO classification were selected for the evaluation. Patients with ossis scaphoidei nonunion and after inadequately treated scapholunate ligament rupture were excluded. The evaluation of post-traumatic arthritis was performed according to the Knirk and Jupiter scale, clinical assessment according to the Modified Mayo Wrist Score. Results: In 2007 and 2008, 749 patients with distal radius fractures were treated, 112 of them with type C according to AO classification. The average age at the time of the fracture in an intraarticular localisation was 53.2 years. 31 patients were invited for a check-up after 11–12 years; a form of radiocarpal arthrosis was diagnosed in 10 of them (32.3 %). The average score in patients without arthrosis was 92.1 points out of 100, in patients with a certain form of arthrosis it was 69.5 points out of 100. Poor clinical outcome was observed in 3 patients with radiocarpal arthrosis. During the reference period, radiocarpal arthrosis developed in 8 patients with a distal radius articular surface deficit of more than 2 mm. None of the patients with radiocarpal arthrosis required surgery. Discussion: In a study by Swedish authors, arthrosis developed in 38 out of 63 monitored patients; the arthrosis did not affect the functional outcome. During a 15-year follow-up of authors from the USA, all 16 patients developed arthrosis after the osteosynthesis of intraarticular distal radius fracture. The functional results did not relate to the grade of arthrosis either. In their thesis, Knirk and Jupiter describe the development of arthrosis in 91 % in 6 years after the intraarticular radius fracture surgery. 52 out of 66 patients in another study from Sweden achieved a good functional result in 9–13 years regardless of the type of fracture; arthrosis developed in one of them only. Conclusion: Fractures of the distal radio, interfering with the radiocarpal joint with a deficit of more than 2 mm, represent a major risk factor for the development of post-traumatic arthrosis, leading to painful restriction in wrist function. Despite this finding, however, wrist function is often acceptable to patients, without the need of indication for surgery.

Hospital Znojmo p o Orthopaedics Traumatology Department

Trauma Hospital in Brno Department of Traumatology Faculty of Medicine Brno