scholarly journals The relationship between radiographic parameters and clinical outcome of distal radius fractures in elderly patients

2015 ◽  
Vol 101 (7) ◽  
pp. 827-831 ◽  
Author(s):  
L. Cai ◽  
S. Zhu ◽  
S. Du ◽  
W. Lin ◽  
T. Wang ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Elderly Patients ◽  
Distal Radius ◽  
Distal Radius Fractures ◽  
Radius Fractures ◽  
Radiographic Parameters ◽  
The Relationship

scholarly journals The relationship between radiological alignment of united distal radius fractures and functional and patient-perceived outcomes in elderly patients

2017 ◽  
Vol 25 (1) ◽  
pp. 230949901668497 ◽  
Author(s):  
Erik Hohmann ◽  
Mahendrakumar Meta ◽  
Vasudev Navalgund ◽  
Kevin Tetsworth
Keyword(s):  
Elderly Patients ◽  
Grip Strength ◽  
Distal Radius ◽  
Distal Radius Fractures ◽  
Ulnar Variance ◽  
Pinch Strength ◽  
Radius Fractures ◽  
Radial Inclination ◽  
Perceived Outcomes ◽  
The Relationship

Purpose: The purpose of this study was to investigate the relationship between radiological alignment and functional outcomes including strength, range of motion (ROM), and disabilities of the arm, shoulder, and hand (DASH) and patient-rated wrist evaluation (PRWE) scores in elderly patients with united distal radius fractures. Methods: We reviewed 118 patients (mean age of 76.2 ± 9.5 years, mean follow-up 36.3 ± 17.6 months). Outcome measures included the DASH and PRWE scores, ROM, and grip and pinch strength were measured using a validated mobile hand-held dynamometer. Radial height, radial inclination, ulnar variance, and palmar tilt were measured on standard radiographs. Results: The mean total score for DASH was 4.9 ± 7.4 and 6.9 ± 11 for the PRWE. There were significant differences in ROM for palmar flexion and ulnar deviation between the affected wrist and the normal wrist. Linear regression revealed significant relationships for the following variables: between DASH and radiological palmar tilt, between PRWE and radiological palmar tilt, between grip strength and radial inclination, between grip strength and radial height, and between grip strength and ulnar variance. Conclusion: This study suggests that minor deformities of the distal radius following distal radius fractures treated with either operative or nonoperative treatment are unlikely to be clinically relevant and have no impact on patient perceived outcomes for elderly patients.

Association between Functional Outcomes and Radiographic Reduction Following Surgery for Distal Radius Fractures

2019 ◽  
Vol 24 (03) ◽  
pp. 258-263
Author(s):  
Ronit Wollstein ◽  
Raviv Allon ◽  
Yoav Zvi ◽  
Alan Katz ◽  
Sharon Werech ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Outcome Measures ◽  
Distal Radius ◽  
Functional Outcomes ◽  
Distal Radius Fractures ◽  
Ulnar Variance ◽  
Radius Fractures ◽  
Radial Inclination ◽  
Radiographic Parameters ◽  
Radiographic Measurements

Background: Quality of reduction in distal radius fractures (DRF) is assessed using radiographic parameters, however few studies examine the association between radiographic measurements and functional outcomes. Our purpose was to evaluate the relationship between radiographic measurements and clinical outcome measures following surgery for DRF using detailed testing to demonstrate further associations between post-surgical radiographic measurements and function. Methods: Measurements were performed on postoperative radiographs of 38 patients following ORIF of DRF. Measurements included: radial inclination, radial height, ulnar variance, volar tilt, radiocarpal interval (d2/w2), and the intra-articular step-off. Clinical outcome measures included motion, grip strength, functional dexterity testing, Moberg pick-up test, specific activities of daily living, DASH score, pain scale, manual-assessment questionnaire. Results: Different radiographic parameters correlated with different specific tasks. The parameter correlated with most functional tasks was ulnar-variance. Radial inclination, radial-styloid scaphoid distance, and fracture classification correlated with some functions. Intraarticular step-off, and radial height were not associated with functional testing. Conclusions: Surgical radiographic results may affect post-operative function. Detailed task specific testing may enable a better evaluation of surgical outcomes. Further study and refinement of functional assessment may change our surgical goals in DRF.

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

2017 ◽  
Vol 43 (2) ◽  
pp. 142-147 ◽  
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

COMPARISON BETWEEN CAST IMMOBILIZATION VERSUS VOLAR LOCKING PLATE FIXATION OF DISTAL RADIUS FRACTURES IN ACTIVE ELDERLY PATIENTS, THE ASIAN PERSPECTIVE

Hand Surgery ◽  
2014 ◽  
Vol 19 (01) ◽  
pp. 19-23 ◽  
Author(s):  
Ying-Ho Chan ◽  
Tun-Lin Foo ◽  
Chong-Jin Yeo ◽  
Winston Yoon-Chong Chew
Keyword(s):  
Elderly Patients ◽  
Internal Fixation ◽  
Distal Radius ◽  
Locking Plate ◽  
Plate Fixation ◽  
Distal Radius Fractures ◽  
Current Evidence ◽  
Volar Locking Plate ◽  
Radius Fractures ◽  
Cast Immobilization

Displaced distal radius fractures in active elderly patients with high functional demand present a clinical dilemma because current evidence is equivocal in the recommendation of treatment. Internal fixation is an increasingly popular option with proposed superior results. Our study aims to evaluate the results among a population of active elderly patients with displaced fractures managed with either cast immobilization or internal fixation with volar locking plate. Seventy-five patients (35 cast immobilization and 40 internal fixation) with mean age of 74 ± 7.5 years with minimum of 12 months follow-up were studied. The radiological and clinical parameters were assessed at three, six, and 12 months. Functional outcomes (DASH, Green-O'Brien) were assessed at 12 months. Patients who underwent surgery regain wrist motion and grip strength earlier, but this was not statistically significant after six months.

scholarly journals CLINICAL OUTCOME OF INTRA - ARTICULAR DISTAL RADIUS FRACTURES TREATED WITH PLATE AND SCREWS

2015 ◽  
Vol 04 (18) ◽  
pp. 3110-3123
Author(s):  
Girish K R ◽  
Hosangadi A A ◽  
Suresh Korlhalli ◽  
Suryakanth K
Keyword(s):  
Clinical Outcome ◽  
Distal Radius ◽  
Distal Radius Fractures ◽  
Radius Fractures

scholarly journals The Necessity of Restoration of Radiologic Parameters by Closed Reduction in Elderly Patients with Distal Radius Fractures

2019 ◽  
Vol 25 ◽  
pp. 6598-6604 ◽  
Author(s):  
Lingde Kong ◽  
Ningzhao Kou ◽  
Yanxue Wang ◽  
Jian Lu ◽  
Dehu Tian ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Distal Radius ◽  
Closed Reduction ◽  
Distal Radius Fractures ◽  
Radius Fractures

scholarly journals Partially Healed Malaligned Distal Radius Fracture. Surgical Treatment in Patients older than 70 Years

2020 ◽  
Vol 48 (01) ◽  
pp. 020-026
Author(s):  
Marcos Cruz-Sánchez ◽  
Jaime De la Torre-Rojo ◽  
Cristóbal Martínez-Andrade
Keyword(s):  
Surgical Treatment ◽  
Elderly Patients ◽  
Distal Radius Fracture ◽  
Distal Radius ◽  
Fracture Pattern ◽  
Distal Radius Fractures ◽  
High Rate ◽  
Radius Fracture ◽  
Radius Fractures ◽  
Mayo Wrist Score

Abstract Introduction Management of distal radius fractures remains controversial despite their high frequency. Elderly patients specifically present a high rate of secondary displacement, sometimes requiring a complex reconstructive surgery. The surgical treatment of displaced fractures evolving for several weeks in elderly patients has not been clearly reflected in the literature. This study aims to show clinical and radiological outcomes from this particular situation. Material and Methods Retrospective study of 31 cases of distal radius fractures with more than 2 weeks of evolution. Fractures were graded according to the Fernández's classification. Pre- and postoperative radiological studies were carried out to evaluate the degree of correction achieved. A clinical evaluation was performed using the Mayo Wrist Score. Data on arthroscopy and bone substitutes use, specific surgical tips and complications were also collected. Results Thirty-one patients with a mean age of 76 years old were operated for distal radius fracture with a delay in surgical treatment of 22 days. The most frequent fracture pattern was Fernández type III (38.7%). The clinical outcome according to the Mayo Wrist Score was 81.94 points with no relationship to fracture pattern or arthroscopic assistance. A statistically significant improvement was achieved for the correction of radial inclination, joint gap and ulnar variance. No statistically significant improvement was achieved in volar tilt correction. Complications were observed in 12.9% of the cases. Conclusions Delayed surgical treatment of distal radius fracture in elderly patients provides similar results to those observed in other age groups and time of evolution. Despite not being the ideal scenario for the surgeon, it should be considered to avoid functional deterioration in this fragile age group.

Radiographic Outcomes and Complications of Delayed Fixation of Distal Radius Fractures

Hand ◽  
2020 ◽  
pp. 155894472093030
Author(s):  
Stella J. Lee ◽  
Derek S. Stenquist ◽  
Jamie E. Collins ◽  
Ariana N. Mora ◽  
Brett A. Teplitz ◽  
...  
Keyword(s):  
Cohort Study ◽  
Surgical Treatment ◽  
Distal Radius ◽  
Distal Radius Fractures ◽  
X Rays ◽  
Matched Cohort ◽  
Radius Fractures ◽  
Radiographic Outcomes ◽  
Radiographic Parameters ◽  
Surgical Fixation

Background: Surgeons are sometimes presented with patients with distal radius fractures who present in a delayed fashion or lose reduction after several weeks of attempted closed management. There are limited studies on delayed surgical treatment of distal radius fractures to assist providers in decision-making. Methods: We conducted a matched cohort study to compare radiographic outcomes and complications for patients with a distal radius fracture treated with delayed (3-5 weeks) or early (0-2 weeks) surgical fixation. Patients ages 18+ who underwent open reduction and internal fixation of distal radius fractures by a volar approach at 2 Level I trauma centers between 2003 and 2015 were eligible. We measured radiographic outcomes and reviewed medical records to determine operative approach and complications. Results: There were 25 cases and 50 controls matched for age (18-87), sex, and AO fracture type. The delayed group had surgery at a mean of 24.8 days from injury and the early group at 5.6 days. There was no statistically significant difference between the delayed and early cohorts in radiographic parameters on injury x-rays, in improvement in radiographic parameters on first postoperative x-rays, or in maintenance of radiographic parameters at union. Conclusion: We did not find significant differences in radiographic outcomes or complication rates between patients with delayed versus early surgical treatment for distal radius fracture. Providers treating patients with late presentation or late displacement have the option of surgical fixation beyond the first few weeks after injury. Level of Evidence: III (Retrospective matched cohort study)

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