Evaluation of the Relationship Between Radial Translation and Functional Outcomes in Nonsurgical and Surgically Treated Distal Radius Fractures.

Purpose

This study aimed to evaluate the prognostic importance of radial translation on functional outcomes in patients treated nonoperatively or surgically for distal radial fractures. It was hypothesized that increased radial translation would be associated with worse functional scores, regardless of treatment modality.

Methods

This retrospective comparative study included 130 adult patients (aged 18-70 years) with unilateral AO/OTA 2R3A2 distal radius fractures, treated between January 2020 and December 2024. Group 1 (n = 60) underwent closed reduction and plaster casting, whereas group 2 (n = 70) underwent open reduction and volar locking plating performed by a consultant hand surgeon. Disabilities of the Arm, Shoulder, and Hand (DASH) scores and standard wrist radiographs were analyzed in patients with at least 12 months of clinical follow-up. Radiographic parameters, including radial inclination, radial length, volar tilt, ulnar variance, and radial translation, were assessed. Outcomes were assessed using the DASH score, visual analog scale pain scores, and the goniometric wrist range of motion. Correlation and multivariable regression analyses were performed to identify independent predictors of the DASH scores.

Results

A total of 130 patients were included. Across the entire cohort, radial translation demonstrated the strongest association with patient-reported disability, showing a substantial positive correlation with DASH scores (R2 = 0.763). Other radiographic parameters, including radial length, ulnar variance, volar tilt, and radial inclination, showed only weak or minimal correlations with functional outcomes. Pain scores and wrist range of motion measurements did not display meaningful radiographic associations. In multivariable analysis, radial translation remained the most important independent variable related to DASH scores, whereas the contributions of other radiographic and demographic factors were limited.

Conclusions

Radial translation is a strong and independent predictor of functional outcomes in distal radius fractures. Intraoperative assessment and correction of coronal alignment, including radial translation, should be emphasized along with sagittal parameters. Routine radiographic assessment of this parameter may improve the functional prognosis.

Type of study/level of evidence

Prognostic III.