Lafontaine criteria and instability assessment of distal end radius fracture

Abstract

          Background: Distal end radius fractures are one of the most common injuries encountered in orthopedic practice. Lafontaine found that presenting 3 or more of dorsal angulation more than 20 degrees, dorsal comminution, intra-articular fracture, associated ulnar fracture and age over 60 years were considered as factors of secondary displacement. But later studies found that Lafontaine criteria did not affect all of these factors.

          Objectives: To determine factors of Lafontaine criteria associated with instability of distal end radius fracture from radiographic imaging in treatment with closed reduction and cast.

          Method: Patients with closed reduction and cast in distal end radius fractures, who had radiograph in onset of injury and more than one times follow-up with complete data records, were identified in Tharongchang Hospital from January 1, 2012 to August 31, 2021. Their radiographs were assessed. Follow up on radiographs after treatment about acceptable alignment, record data and statistical analyze data.

          Results: There were 40 participants with mean age 43.40 years (21 males and 19 females). According to Lafontaine criteria, intraarticular fracture affected to instability of distal end radius fracture, statistically significant (Odd ratio 4.865, P-valve 0.027). Other factors were not statistically significant. In terms of components, radial shortening and change in radial inclination affected to age greater than 60 years, dorsal angulation greater than 20 degrees, dorsal comminution and ulnar fracture. While step-off affected to intra-articular fracture. Loss of palmar tilt and extension more than neutral affected to dorsal angulation greater than 20 degrees and dorsal comminution.

          Conclusion: Important parameter for instability after closed reduction and cast in distal end radius fracture was intra-articular fracture.