Gökhan Pehlivanoğlu, Tolga Onay, Engin Eceviz, Hüseyin Günay, Halil İbrahim Bekler
Southern Clinics of Istanbul Eurasia - 2025;36(4):389-396
Objective: Distal radius fractures are among the most common fractures in adults. Open reduction and internal fixation (ORIF) using locking plates represents the standard surgical approach. However, factors influencing functional outcomes after surgery remain controversial. This study assessed how patient characteristics, fracture type, and radiological factors influence functional recovery after distal radius fractures treated with locking plates. Methods: Eighty-one patients (55 males, 26 females; mean age: 43.7 years) who underwent ORIF with locking plates between 2007 and 2013 were retrospectively analyzed. Functional outcomes were assessed using the QuickDASH, PRWE, and Modified Green and O'Brien scoring systems. Radiological evaluations included the Stewart and Knirk & Jupiter classifications. Spearman correlation and group comparison analyses were performed to identify factors associated with functional outcomes. Results: Fracture classification significantly affected functional outcomes, with AO type B fractures demonstrating superior QuickDASH and Modified Green and O'Brien scores compared to type C fractures (p<0.05). Ulnar styloid nonunion did not affect functional outcomes but was associated with higher arthritis grades (p=0.039). PRWE scores were significantly correlated with arthritis severity, radiological reduction quality, patient age, and most wrist range of motion parameters (excluding pronation). Additionally, PRWE scores were negatively correlated with radial inclination and radial height, and positively correlated with ulnar variance. Conclusion: Functional recovery following distal radius fracture surgery is influenced by fracture type, reduction quality, age, arthritis, and wrist mobility. Anatomical reduction and near-complete wrist mobility are key to optimal outcomes.
