EWJ June 61 2025 web - Flipbook - Page 44
lowing conservatively treated Colles' fractures. Injury. 2002;33(1):4146.
Clement ND, Duckworth AD, McQueen MM, Court-Brown CM.
The outcome of fractures of the distal radius in low-demand elderly
patients. J Bone Joint Surg Br. 2011;93(6):676-680.
Chung KC, Kotsis SV, Kim HM. Predictors of functional outcomes
after surgical treatment of distal radius fractures. J Hand Surg Am.
2007;32(1):76-83.
Chung KC, Pillsbury MS, Walters MR, Hayward RA. Reliability and
validity testing of the Michigan Hand Outcomes Questionnaire. J
Hand Surg Am. 1998;23(4):575-587.
MacDermid JC, Roth JH, Richards RS. Pain and disability reported
in the year following a distal radius fracture: a cohort study. BMC
Musculoskelet Disord. 2003;4:24.
Jupiter JB. Current concepts review: fractures of the distal end of
the radius. J Bone Joint Surg Am.1991;73(3):461-469.
Watson JT, Wies JL, Moed BR. Open fractures: principles of management. In: Bucholz RW, Heckman JD, Court-Brown CM, eds.
Rockwood and Green's Fractures in Adults. 6th ed. Lippincott
Williams & Wilkins; 2006.
Schnitzer TJ. Pain mechanisms and management in adults with osteoarthritis. Am J Med. 1997;103(6A):20S–27S.
National Institute for Health and Care Excellence (NICE). Fractures
(non-complex): assessment and management. NICE guideline
[NG38]. February 2016.
British Orthopaedic Association (BOA). BOAST - Management of
distal radial fractures. BOA Standards for Trauma. 2017.
RCSEng and BSSH. Best practice for management of distal radial
fractures. The Royal College of Surgeons of England / British Society for Surgery of the Hand, 2021.
Dilek, B., Dilek, O.C., Atay, A. and Demirhan, M. The incidence of
complex regional pain syndrome after distal radius fracture treated
with volar locking plate. Acta Orthopaedica et Traumatologica Turcica. 2012; 46(5):339-343.
Harden, R.N., Bruehl, S., Perez, R.S., Birklein, F., Marinus, J., Maihöfner, C., Lubenow, T., Buvanendran, A., Mackey, S., Graciosa, J.R.
and Mogilevski, M. Validation of proposed diagnostic criteria (the
“Budapest Criteria”) for Complex Regional Pain Syndrome. Pain.
2010;150(2):268-274.
MacDermid, J.C., Richards, R.S., Donner, A., Bellamy, N. and Roth,
J.H. Responsiveness of the PRWE and DASH outcome measures in
evaluating recovery following a distal radius fracture. Journal of
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The complexities of fracture pattern, treatment choice,
biological healing, patient compliance, and psychosocial overlay all interact to influence recovery. Furthermore, the natural history of wrist fractures, particularly
in older patients, may involve incomplete restoration of
pre-injury status despite appropriate management.
The medicolegal expert must provide nuanced, fair,
and evidence-based reports that clearly identify foreseeable complications, recognise the limits of predictability, and distinguish between complications that
fall within the natural history of injury versus those
that may reflect suboptimal care. Understanding the
variability in outcome is not only critical for assessing
damages but also for managing expectations - for
patients, clinicians, and the courts.
A well-structured, transparent, and clearly referenced
medicolegal report remains the cornerstone of effective expert evidence in this field. Expert analysis that
is clinically grounded, logically argued, and clearly explained plays a crucial role in securing justice for
claimants and defending professionals alike.
References
Court-Brown CM, Caesar B. Epidemiology of adult fractures: A
review. Injury. 2006;37(8):691-697.
Handoll HH, Madhok R. Conservative interventions for treating
distal radial fractures in adults. Cochrane Database Syst Rev.
2003;(2):CD003209.
Arora R, Lutz M, Deml C, Krappinger D, Haug L, Gabl M. A
prospective randomized trial comparing nonoperative treatment
with volar locking plate fixation for displaced and unstable distal radial fractures in patients sixty-five years of age and older. J Bone Joint
Surg Am. 2011;93(23):2146-2153.
MacIntyre NJ, Dewan N. Epidemiology of distal radius fractures and
factors predicting risk and prognosis. J Hand Ther. 2016;29(2):136145.
Karnezis IA, Fragkiadakis EG. Association between objective clinical
and radiological parameters and patient-rated wrist evaluation fol-
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