The Role of Wrist Circumference (Regional Obesity Versus Local Swelling) in Conservatively Treated Distal Radius Fractures: A Single Center Experience

Aim: Regional obesity around the wrist due to local excessive fat or local swelling due to edema has not been studied as a risk factor to predict the possibility of reduction loss during conservative treatment of distal radius fractures. We aimed to investigate the impact of wrist circumference on reduction loss risk in conservatively treated distal radius fractures. Material and Methods: Patients with distal radius fractures who were conservatively in our institution between January 2021 and December 2021 are retrospectively reviewed. Patients’ demographics, wrist circumference, radiographic parameters were obtained from hospital registry notes. Wrist circumference was measured with an unstretchable tape positioned on a line passing from lister tubercle of the distal radius and distal ulna. The difference in the wrist circumferences between the injured and uninjured extremities represented local swelling. The association of these factors with reduction loss was evaluated. Results: A total of 73 consecutive patients (19 male, 54 female) with a mean age of 61.1 ± 12.9 were included. There were 18 reduction losses. There was no association with reduction loss between injured and uninjured wrist circumferences (p>0.05). However, local swelling, initial displacement at dorsal angulation and radial inclination, presence of dorsal comminution, and accompanying ulnar styloid fracture were associated with reduction loss (p<0.05). Local swelling had an odd ratio of 6.661 (1.848 – 24.006, p= 0.004). Conclusion: Excessive local swelling is found to be a risk factor to predict reduction loss in conservative treatment of distal radius fractures while regional obesity is not.