[Instability of fractures of the lower end of the radius: apropos of a series of 167 cases].

One-hundred-sixty-seven consecutive cases of distal radius fracture have been treated in our department from October 1985 until November 1987. All cases were rated according to anatomical criteria defined on the first radiogram. These criteria were the presence of a dorsal tilt greater than 20 degrees, dorsal comminution, intra-articular radiocarpal involvement, an associated fracture of the ulna and comminution of the distal radius. Age greater than 60 years was also considered as a factor in determining severity. With regard to fractures treated conservatively (from which comminuted fractures were excluded), a strong correlation was found between the sum of these factors and the risk of secondary displacement. This complication occurs despite a satisfactory initial reduction. Although the surgically treated cases were more severe, significantly better radiological results were observed following surgical management. This mode of classification of distal radius fractures is helpful for determining prognosis and evaluating the risk of secondary displacement and in the course, should help in the selection, perhaps earlier of the most appropriate treatment.