الفهرس 
INTRODUCTION
Radiological AnatomyOnly 14 pages are availabe for public view
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Abstract
Fractures of the distal end radius have been discussed in the surgical literature for over two hundred years. They represent one sixth of all fractures in patients over 50 years of age.
The injury produced depends on the position of the wrist,the magnitude and the direction of force, and the physical properties of the bone. Dorsal displacement of the distal radius fracture results from falls on the outstretched hand with the wrist in 40 to 90 degrees of dorsiflexions.(3)
Fractures of the distal radius with palmar displacement are attributed to more than one mechanism of injury. A fall with the forearm in supination followed by pronation around a fixed extended wrist may be the more common mechanism of injury.
The correlation between radiological parameters and objective physical variables is controversial, and the relationship between these traditional objective measurements and the patient-perceived outcome is not entirely clear. Patient-rating scales that aim to quantify the patient’s perceived disability have been developed to provide a more comprehensive assessment after injuries and, increasingly, are being used to evaluate the results after treatment of distal radius fractures.
The aim of this work was to correlate between radiological and clinical outcome in fracture lower end radius in old age.
The mean age of the patients was 68 years. That means that active patients sustain such fractures and appropriate treatment is crucial for their return to work and daily activities. The age is directly related with the force of injury as well as with the biomechanics and strength of the cortical bone. The gender rate was women: men 3:2 and is most probably related to the osteoporosis commonly seen in aged women.
In this study the correlation of clinical outcome with the radiological parameters was the main objective. Previous studies showed that the reduction of the articular surface was closely related to the final functional outcome[2,29]. Other authors concluded that radial shortening more than 2mm and radial angulation more than 15° were directly associated with poor functional outcome[23]. In our study the cases with poorly corrected radial length and dorsal angulation were the patients with moderate or poor functional outcome.
However, wrist function was satisfactory by the same patients and they did not ask for any surgical intervention. We must mention that most of these patients were older than 70 year.
At the end of the follow up period, 15 patients (60 %) had excellent results according to Sarmiento modification of Gartland & Werley functional scoring system (scores between 0 and 2), 7 patients (18%) had good results (scores between 3 and 8) and 3 patients (12%) had fair results (scores between 9 -21).No patients were graded as poor results. The satisfactory results (excellent and good) were in 22 patients (88%) and the unsatisfactory results (fair and poor) were in 3 patients (12%). The results were satisfactory in 88% of cases.
There was no statistically significant relation between patients’ age and sex and final clinical score.
Correlations between different clinical measurements at the end of the follow up period and final clinical score showed statistical significant differences regarding dorsal flexion, palmar flexion, pronation, supination, radial deviation, ulnar deviation and grip strength.
Three patients presented with stiff finger immediately after removal of the cast. However, none of the patients showed any complication at the end of the follow up.