Abstract
Background Unstable distal radius fractures are a popular research subject. However, to appreciate
the findings of studies that enrolled patients with unstable distal radius fractures,
it should be clear how the authors defined an unstable distal radius fracture.
Questions In what percentage of studies involving patients with unstable distal radius fractures
did the authors define unstable distal radius fracture? What are the most common descriptions of an unstable distal radius fracture? And
is there one preferred evidence-based definition for future authors?
Methods A systematic search of literature was performed to identify any type of study with
the term unstable distal radius fracture. We assessed whether a definition was provided and determined the level of evidence
for the most common definitions.
Results The search yielded 2,489 citations, of which 479 were included. In 149 studies, it
was explicitly stated that patients with unstable distal radius fractures were enrolled.
In 54% (81/149) of these studies, the authors defined an unstable distal radius fracture.
Overall, we found 143 different definitions. The seven most common definitions were:
displacement following adequate reduction; Lafontaine's definition; irreducibility;
an AO type C2 fracture; a volarly displaced fracture; Poigenfürst's criteria; and
Cooney's criteria. Only Lafontaine's definition originated from a clinical study (level
IIIb).
Conclusion In only half of the studies involving patients with an unstable distal radius fracture
did the authors defined what they considered an unstable distal radius fracture. None of the definitions stood out as the preferred choice. A general consensus definition
could help to standardize future research.
Keywords
unstable distal radius fracture - instability - generalizability - systematic review
- definition
