{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T01:08:34Z","timestamp":1786669714755,"version":"build-2736575974"},"reference-count":26,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2025,9,29]],"date-time":"2025-09-29T00:00:00Z","timestamp":1759104000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,9,29]],"date-time":"2025-09-29T00:00:00Z","timestamp":1759104000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Hand Surg Eur Vol"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>The optimal timing for distal radial fracture fixation remains controversial. Most previous studies have dichotomized timing into early or delayed categories, potentially obscuring the true effect of delay. This study investigated surgical timing as a continuous variable to determine its influence on radiographic alignment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>In a retrospective multicentre cohort study, we reviewed 691 surgically treated distal radial fractures across four Swedish hospitals. Radiographic parameters assessed included dorsal tilt (primary outcome), radial inclination, ulnar variance, intra-articular step, coronal shift and anterior apposition. Logistic regression was used to analyse overall acceptable alignment, while linear regression was used for dorsal tilt. Models were adjusted for age and sex. Interobserver reliability was evaluated with intraclass correlation coefficients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>The mean patient age was 61 years, and 80% of the cohort were female. Each additional day delay to surgery increased the risk of unacceptable alignment by 6%, corresponding to a twofold risk increase with a 2 week delay. Dorsal tilt worsened linearly by approximately 0.34\u00b0 per day, accumulating to nearly 5\u00b0 after 2 weeks. Male sex was associated with significantly greater dorsal tilt (mean difference &gt;2\u00b0) and reduced correction compared with females. Interclass correlation coefficients demonstrated excellent reliability for dorsal tilt (0.952) and radial inclination (0.947), and moderate reliability for ulnar variance (0.748) and coronal shift (0.611).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>A linear relationship was identified between surgical delay and declining radiographic outcomes, highlighting that each day\u2019s delay progressively compromises fracture alignment. These findings emphasize the importance of prompt surgical intervention for distal radial fractures to achieve optimal radiographic results.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of evidence:<\/jats:title>\n                    <jats:p>\n                      <jats:bold>III<\/jats:bold>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/17531934251379171","type":"journal-article","created":{"date-parts":[[2025,9,29]],"date-time":"2025-09-29T08:51:47Z","timestamp":1759135907000},"page":"173-178","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["Radiographic outcomes decline linearly with increased time to surgery in distal radius fractures: A cohort analysis"],"prefix":"10.1177","volume":"51","author":[{"given":"Mats","family":"Wadsten","sequence":"first","affiliation":[{"name":"Department of Diagnostics and Intervention (Orthopaedics), Ume\u00e5 University, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Albert","family":"Christersson","sequence":"additional","affiliation":[{"name":"Department of Surgical Sciences\/Orthopaedics, Uppsala University, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana","family":"Farah-Mwais","sequence":"additional","affiliation":[{"name":"Department of Diagnostics and Intervention (Orthopaedics), Ume\u00e5 University, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magnus","family":"T\u00e4gil","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences Lund, Orthopedics, Lund University, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emma","family":"Haskovec","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Ryhov Hospital, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus","family":"Engquist","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Ryhov Hospital, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8727-9555","authenticated-orcid":false,"given":"Viktor","family":"Schmidt","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences at Danderyd Hospital, Karolinska Institutet, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,9,29]]},"reference":[{"key":"e_1_3_3_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.332.7549.1080"},{"key":"e_1_3_3_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/1753193420936591"},{"key":"e_1_3_3_4_1","article-title":"Outcomes of volar plating distal radius fractures based on surgical timing","author":"Campbell BR","year":"2023","unstructured":"Campbell BR, Reyes AA, Neustein TM, Miller AJ. Outcomes of volar plating distal radius fractures based on surgical timing. Hand NY. 2023: 15589447231198264.","journal-title":"Hand NY"},{"key":"e_1_3_3_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrrheum.2014.164"},{"key":"e_1_3_3_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hcl.2005.03.002"},{"key":"e_1_3_3_7_1","article-title":"Impact of time to fixation on outcomes of operative treatment of intra-articular distal radius fractures","volume":"19","author":"Grier AJ","year":"2024","unstructured":"Grier AJ, Chen KJ, Paul AV, et al. Impact of time to fixation on outcomes of operative treatment of intra-articular distal radius fractures. 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Curr Orthop Pract. 2023, 34: 229\u201335.","journal-title":"Curr Orthop Pract"},{"key":"e_1_3_3_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhsa.2024.07.006"},{"key":"e_1_3_3_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhsa.2022.12.018"},{"key":"e_1_3_3_14_1","doi-asserted-by":"publisher","DOI":"10.1080\/17453674.2017.1303601"},{"key":"e_1_3_3_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhsa.2015.01.023"},{"key":"e_1_3_3_16_1","article-title":"Radiographic outcomes and complications of delayed fixation of distal radius fractures","volume":"17","author":"Lee SJ","year":"2022","unstructured":"Lee SJ, Stenquist DS, Collins JE, et al. Radiographic outcomes and complications of delayed fixation of distal radius fractures. Hand NY. 2022, 17: 748\u201353.","journal-title":"Hand NY"},{"key":"e_1_3_3_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2011.03.031"},{"key":"e_1_3_3_18_1","unstructured":"Mellstrand Navarro C. 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