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

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.