No long-term risk of wrist osteoarthritis due to subchondral haematomas in distal radial fractures

Abstract

Objective: The objective of this study of distal radius fractures was to determine if a subchondral haematoma in an unfractured compartment predicts secondary osteoarthritis.

Methods: In 1995–1997, 41 patients, 22 women, a median age of 41 years (20–57 years) with a displaced distal radius fracture underwent diagnostic wrist arthroscopy in addition to the fracture treatment. In 12 patients (7/12 women), subchondral haematomas were identified in a joint compartment not involved in the fracture.

Results: At 13–15 years, 37 patients were still alive. Twenty-eight patients attended the follow-up and 8/28 had had a subchondral haematoma within an uninjured compartment at the time of arthroscopy. The range of motion at 13–15 years was impaired in the injured wrist, but unrelated to the presence of a subchondral haematoma. The mean grip strength in patients with subchondral haematoma was 80% of the contralateral, compared to 78% in patients without. No correlation was found between the presence of a subchondral haematoma at arthroscopy and the development of radiographic osteoarthritis in the long term.

Conclusion: The presence of a subchondral hematoma in an uninjured compartment at the time of fracture did not alter the long-term clinical or radiographic outcome after a distal radius fracture.

Keywords:

• Bone bruise
• cartilage
• distal radial fracture
• long-term outcome

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

The project was supported by the Swedish Research Council (project 2031), Greta and Johan Kock, Alfred Österlund, Maggie Stephens, Thure Carlsson foundations and the Medical Faculty of Lund.