Incidence of distal radius fractures is approximately 1 in 10,000 people, and they account for 16 percent of all fractures and 74 percent of forearm fractures treated by orthopedic surgeons4. The prevalence of the disease is equal in all age groups, but the most dramatic increases are observed in elderly women and young males 19,8,17. In this case, two different types of injuries are represented: insufficiency fractures in elderly patients and traumatic injury in young males. Accidentally falling over an outstretched hand is the most common type of trauma. Injury in younger adults is more evenly distributed between males and females12.Overall, elderly patients are more willing to accept more displacement (as well as closed treatment) than young patients, but some continue to have poor outcome. Elderly patients function reasonably well despite the development of a malunion; however, elderly patients with low functional demands or with frailty constituted the bulk of studies showing acceptable function6. When Madhok looked at elderly patients who had not undergone surgery, they found that 26 percent had functional impairment5.Since Colle's proclamation (1814), the management of the distal radius undergone remarkable evolution, progressing from universal cast treatment, pinning, bridging external fixator, buttress plating, dorsal locking plates, advanced palmar locking plates, among other advancements. Recent research has concluded that the restoration of normal anatomy has a positive correlation with the restoration of functional outcome. As little as one mm of incongruity of the articular area has been associated with poor outcomes9, according to Fernandez, Trumble, and others.A number of other studies have discovered no link between radiographic arthrosis & functional outcomes. Treatment options such as closed or open reduction and internal fixation as well as early recognition and repair of concomitant injuries, as well as rehabilitation under the oversight of highly skilled therapists, are all required for optimal management to be realised.

A prospective, cross-sectional investigation was conducted in the Department of Orthopedics, ASRAM medical college, Eluru, over a period of two years (2019–2021). A total of 30 Patients aged between 20 to 70 years with distal radius fracture attending emergency department were studied. Patients with unstable, comminuted, or intra-articular fractures of the distal end of the radius, both male and female patients included. STATISTICAL ANALYSIS: Data entry was done using M.S. Excel and it statistically analysed using Statistical package for social sciences (SPSS Version 16) for M.S Windows. Descriptive statistical analysis was carried out to explore the distribution of several categorical and quantitative variables. Categorical variables were summarized with n (%), while quantitative variables were summarized by mean ± S.D. All results are presented in tabular form and are also shown graphically using bar diagram or pie diagram as appropriate. Inferential Statistics: The difference in the two groups were tested for Statistical Significance and categorical variables tested by chi square test. P- value less than 0.05 considered to be statistically significant.

Majority of the patients belonged to the age group of 21-30 years (26.7%) and 31-40 years (23.3%) followed by <20 years (16.7%), 41-50 years (16.7%), 51-60 years (13.3%) and 61-70 years (3.3%). Table 1: Distribution of patients based on the age group Frequency Percent Age Group <20 years 5 16.7% 21-30 years 8 26.7% 31-40 years 7 23.3% 41-50 years 5 16.7% 51-60 years 4 13.3% 61-70 years 1 3.3% Total 30 100.0% Table 2: Distribution of patients based on the gender Frequency Percent SEX Male 15 50.0% Female 15 50.0% Total 30 100.0% Table 3: Distribution of patients based on the side involved Frequency Percent Side involved Left 13 43.3% Right 17 56.7% Total 30 100.0% Left was involved in 43.3% patients and right was involved in 56.7% patients. Table 4: Distribution of patients based on the mode of injury Frequency Percent MODE OF INJURY FOOH 13 43.3% RTA 17 56.7% Total 30 100.0% Table 5: Distribution of patients based on the frykman classification of distal radial fractures Frequency Percent FRYKMAN I 4 13.3% II 10 33.3% III 6 20.0% IV 3 10.0% V 2 6.7% VI 1 3.3% VII 4 13.3% Total 30 100.0% Frykman classification of distal radial fractures showed type I in 13.3% patients, type II in 33.3% patients, type III in 20% patients, type IV in 10% patients, type V in 6.7% patients, type VI in 3.3% patients and type VII in 13.3% patients. Table 6: Distribution of patients based on the AO type classification of distal radial fractures Frequency Percent AO Type A2 4 13.3% A3 6 20.0% B2 8 26.7% B3 5 16.7% C1 7 23.3% Total 30 100.0% AO type classification of distal radial fractures showed type A2 in 13.3% patients, type A3 in 20% patients, type B2 in 26.7% patients, type B3 in 16.7% patients and type C1 in 23.3% patients.

Distal radial fractures are one of the most common injuries that orthopedic surgeons encounter in their practice. Up until a few decades ago, distal radius fractures were usually regarded as ‘Colles’ fracture. The treatment was mainly manipulation and casting, proposed by Abraham Colles’ in 18147, however they would heal with a deformity but with acceptable functional deficits. The expected and acceptable outcome of the fractures would be based on various factors such as age of the patient, occupation and hand dominance. Fracture union is no longer the only goal, as the restoration of normal anatomy with early functional recovery, and restoration of full range of motion of wrist and forearm are the ultimate goals of treatment. With better understanding of the various fracture types, classification such as Frykman16, Melone18, and AO11 were developed. There was a need for better modality of treatment according to individual fracture pattern to obtain better functional results. According to the current study, the outcome was excellent in 33.3 percent of the patients, good in 53.3 percent of the patients, and fair in the remaining 13.3 percent of the patients. Outcome measures were lateral pinch strength, grip strength, wrist range of motion,the Jubsen Taylor test, and the Michigan hand questionnaire when compared to the normal side, according to Kevin C. Chung and colleagues 13. In his series, the mean grip strength, the mean pinch strength, and the mean flexion of the wrist were all reduced by 86 percent compared to the normal side.In the study by Anakwe RE et al.,, 2 system outcome was assessed using grip strength measures obtained during the clinical examination, radiographs, and patient related wrist evaluation scoring system. A very high level of patient satisfaction, a good functional outcome, and an increase in grip strength were observed in his series of 95 percent patients.As a result of using the modified Green and Obrein score, Arora R et al. 3, he received 31 excellent, 54 good, 23 fair, and 6 poor results.Agarwala S et al., 1 used mayo modified wrist score for interpreting results, which showed 100% of excellent results after one year follow-up.Marlow WJ et al., 15 treatments of unstable distal radius fractures with variable angle LCP resulted in excellent clinical outcomes at 1 year follow-up our series is comparable to that of Khatri K et al., 14 who had 65% excellent, 35% good, results. Radial fractures at the distal end are more common in people in their third to fifth decades. The majority of fractures in younger people is caused by RTA or high-energy trauma, and is typically intra-articular and displaced. The fractures that occur in the elderly will be caused by a minor fall on an outstretched hand, resulting in an extra articular fracture in the osteoporotic bone. The mode of injury is either a RTA or a fall on the outstretched hand, depending on the situation. Distal radial fractures caused by road traffic accidents (high energy trauma) are predominantly intra-articular, displaced, and unstable (Frykman Types III - VIII), and AO types B2, B3, C1, and C3 are the most common types of radial fractures. AKNOWLEDGEMENT We are profoundly grateful to the Principal, Department Head, and our Guide for their indispensable permission, steadfast support, and expert insights that facilitated the completion of this study. CONFLICTS OF INTEREST None

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