The Effect of Immobilization Position on Functional Outcomes and Complications Associated With the Conservative Treatment of Distal Radius Fractures: A Systematic Review

Abstract Background Distal radius fractures are one of the most common fractures seen in the elderly. The management of distal radius fractures in the elderly, especially patients older than 80 years, has not been well defined. The purpose of this study was to evaluate operative treatment of distal radius fractures in patients older than 80 years to determine functional outcomes and complication rates. Materials and Methods A retrospective review was performed to identify patients 80 years or older who were treated for a distal radius fracture with open reduction and internal fixation (ORIF). Medical records were reviewed for demographics, medical history, functional outcomes including quick Disabilities of the Arm, Shoulder, and Hand (qDASH), radiographs, and postoperative complications. Results There were 40 patients included for review. Average age was 84 years. The preoperative qDASH score was 69. At 6 months follow-up, the postoperative qDASH score was 13 (p < 0.001). There were five (12.5%) complications reported postoperatively. All fractures healed with adequate radiographic alignment and there were no hardware failures. Conclusion Distal radius fractures in patients older than 80 years treated with ORIF have good functional outcomes and low complication rates. Increased functionality and independence of the elderly, as well as updated implant design can lead to the effective surgical management of these patients. When indicated from a clinical perspective, operative fixation of distal radius fractures should be considered in patients older than 80 years.

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Functional Outcomes of Percutaneous K-Wire Fixation for Distal Radius Fractures with or without Osteoporosis

Journal of the Korean Fracture Society ◽

10.12671/jkfs.2013.26.4.248 ◽

2013 ◽

Vol 26 (4) ◽

pp. 248

Author(s):

Ki-Chan An ◽

Gyu-Min Kong ◽

Jang-Seok Choi ◽

Hi-Chul Gwak ◽

Joo-Yong Kim ◽

...

Keyword(s):

Distal Radius ◽

Functional Outcomes ◽

Distal Radius Fractures ◽

Radius Fractures ◽

Wire Fixation

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Intra-articular distal radius fractures in elderly patients: a randomized prospective study of casting versus volar plating

Journal of Hand Surgery (European Volume) ◽

10.1177/1753193417727139 ◽

2017 ◽

Vol 43 (2) ◽

pp. 142-147 ◽

Cited By ~ 27

Author(s):

Daniel Martinez-Mendez ◽

Alejandro Lizaur-Utrilla ◽

Joaquin de-Juan-Herrero

Keyword(s):

Conservative Treatment ◽

Elderly Patients ◽

Distal Radius ◽

Articular Surface ◽

Distal Radius Fractures ◽

Volar Plating ◽

Radius Fractures ◽

Level Of Evidence ◽

Loss Of Reduction

We compared outcomes in elderly patients with intra-articular distal radius fractures treated by closed reduction and plaster immobilization or open reduction and internal fixation with a volar plate. Ninety-seven patients older than 60 years were randomly allocated to conservative (47 patients) or surgical (50 patients) treatment. Over a 2-year period, we assessed patient-rated wrist evaluation score, DASH (disability arm, shoulder and hand) questionnaire, pain, wrist range of motion, grip strength, and radiological parameters. The functional outcomes and quality of life were significantly better after volar plating fixation compared with conservative treatment. We found that restoration of the articular surface, radial inclination, and ulnar variance affected the outcomes, but the articular step-off did not. Twenty-five per cent of the patients with conservative treatment had secondary loss of reduction. We conclude that surgical plating leads to better outcomes than conservative treatment for elderly patients with intra-articular distal radius fractures. Level of evidence: I

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Optimal screw length in volar locking plate osteosynthesis for distal radius fractures: a systematic review

ANZ Journal of Surgery ◽

10.1111/ans.17390 ◽

2021 ◽

Author(s):

Rajitha Gunaratne ◽

Omid Nazifi ◽

Harry D'Souza ◽

Aaron Tay

Keyword(s):

Systematic Review ◽

Distal Radius ◽

Locking Plate ◽

Plate Osteosynthesis ◽

Distal Radius Fractures ◽

Volar Locking Plate ◽

Radius Fractures ◽

Screw Length ◽

Locking Plate Osteosynthesis

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Predictors of early and late instability following conservative treatment of extra-articular distal radius fractures

Archives of Orthopaedic and Trauma Surgery ◽

10.1007/s00402-003-0597-6 ◽

2004 ◽

Vol 124 (1) ◽

pp. 38-41 ◽

Cited By ~ 58

Author(s):

Jaydeep K. Moro ◽

R. Brett Dunlop ◽

Anthony Adili ◽

Scott McKenzie ◽

James Leone ◽

...

Keyword(s):

Conservative Treatment ◽

Distal Radius ◽

Distal Radius Fractures ◽

Radius Fractures ◽

Late Instability

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Wrist function in malunion: Is the distal radius designed to retain function in the face of fracture?

Annals of The Royal College of Surgeons of England ◽

10.1308/rcsann.2016.0191 ◽

2016 ◽

Vol 98 (7) ◽

pp. 442-445 ◽

Cited By ~ 2

Author(s):

C Uzoigwe ◽

N Johnson

Keyword(s):

Distal Radius ◽

Comparative Studies ◽

Functional Outcomes ◽

Fracture Pattern ◽

Distal Radius Fractures ◽

Human Species ◽

Radius Fractures ◽

The Face ◽

Preserve Function ◽

Wrist Function

Introduction Fractures of the distal radius are the most common fracture in humans and are the sempiternal hazard of 3.5 million years of bipedalism. Despite the antiquity of the injury, one of the most controversial topics in current orthopaedics is the management of distal radius fractures. It has been suggested that radiographic appearances rarely correlate with functional outcomes. As the success of the human species is predicated almost exclusively on its dexterity and intelligence, it is conceivable that the distal radius has evolved to preserve function even in the face of injury. We therefore hypothesise that the distal radius is designed to accommodate the possibility of fracture. Methods We conducted a review of studies comparing fracture pattern and form with function. We also explore the paleoanthropological evidence and comparative studies with other primates. Findings The evidence points to the human distal radius being highly tolerant of post-fracture deformity in terms of preservation of function. In addition, the distal radius appears to have apparently anatomically ‘redundant’ features that confer this capability. We believe these phenomena to be an evolved trait that developed with bipedalism, increasing the chances of survival for a species whose success depends upon its dexterity.

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The Effect of Socioeconomic Factors on Outcomes of Distal Radius Fractures: A Systematic Review

Hand ◽

10.1177/1558944717735945 ◽

2017 ◽

Vol 13 (5) ◽

pp. 509-515 ◽

Cited By ~ 4

Author(s):

Jessica L. Truong ◽

Chris Doherty ◽

Nina Suh

Keyword(s):

Systematic Review ◽

Socioeconomic Factors ◽

Clinical Outcomes ◽

Distal Radius ◽

Full Text ◽

Distal Radius Fractures ◽

Quality Analysis ◽

Current Evidence ◽

Radius Fractures ◽

Full Text Screening

Background: Socioeconomic factors are known to affect outcomes for both medical and surgical conditions. The purpose of this systematic review was to assess the current evidence regarding the effect of socioeconomic factors such as income, geographic location, educational level, and occupation on clinical outcomes after distal radius fractures. Methods: A systematic search strategy was performed to identify studies commenting on the effect of socioeconomic factors on clinical outcomes following open or closed distal radius fracture repair. Abstract and full-text screening was performed by 2 independent reviewers, and articles were evaluated by Structured Effectiveness Quality Evaluation Scale (SEQES). Treatment outcomes of interest included, but were not limited to, pain, function, range of motion, and grip strength. Results: There were 1745 studies that met our inclusion and exclusion criteria for abstract screening. Of these, 48 studies met our inclusion criteria for full-text screening and 20 studies met our criteria for quality analysis with the SEQES score. There were 3 studies of high quality, 16 of moderate quality, and 1 of low quality. Meta-analyses were not possible due to the variability in outcomes of interest across papers. Conclusions: Patient factors indicative of socioeconomic status are relevant predictors of functional outcome after distal radius fractures. There is currently limited evidence in this area of research, and further examination should be considered to improve outcomes from a patient and system standpoint.

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