Criteria
Risk factors for fracture instability and loss of fracture position[22][45]
Well-known predictors for fracture instability include:
Age >60 years
Substantial initial deformity (>20º dorsal tilt of the articular surface on the lateral x-ray or >5 mm shortening by ulnar variance on the posteroanterior x-ray)
Dorsal comminution
Fracture of the ulna
Displaced articular fracture.
However, one systematic review reported a significant increase in the risk of secondary displacement following reduction in fractures with dorsal comminution, in women and in patients (men and women) aged >60 years.[46] The review concluded that an associated ulna fracture or intra-articular involvement did not result in an increased risk of secondary displacement.
Radiographic features of distal radius fractures that suggest the need for surgical treatment[40]
These include:
Post-reduction radial shortening of >3 mm
Dorsal tilt of >10º
Intra-articular step-off of >2 mm.
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