The clinical importance of carpal instabilities following distal radial fractures.

A prospective study was undertaken to determine the clinical importance of the different carpal instabilities following dorsally displaced distal radial fractures (Colles' type). All patients were followed for 1 year and a Cooney score and X-ray evaluation were done. Nine different carpal instabilities were evaluated. Only dissociative DISI and ulnar translocation showed significant clinical differences at 1 year follow-up. It is therefore recommended that a dissociative DISI, usually caused by scapholunate dissociation, should be treated by percutaneous pinning at the time of the initial treatment.