Epidemiology of Distal Radius Fixations and Functional Outcomes in the Superelderly Population

2020 ◽  
Vol 25 (01) ◽  
pp. 26-31
Author(s):  
Bernice Qi Hui Heng ◽  
Yong Chiang Kang ◽  
Joel Xue Yi Lim ◽  
Kin Ghee Chee
Keyword(s):  
Functional Outcome ◽  
Distal Radius ◽  
Surgical Complications ◽  
Functional Outcomes ◽  
Distal Radius Fractures ◽  
Radius Fractures ◽  
Fracture Union ◽  
Outcome Scores ◽  
Surgical Fixation ◽  
Time To Fracture

Background: Superelderly patients (defined as 80 years old and older) account for 18% of all distal radius fractures in our institution and this number is increasing with the ageing population. When faced with the option of surgery, patients in this age group have concerns with regards to the long term outcomes including functional outcomes and the time to fracture union. Therefore, the aim of this study was to evaluate the functional outcomes in this specific population. Methods: Patient selection for surgery was determined by the fracture stability, the patient’s premorbid function and underlying comorbidities. Post operatively, the time to fracture union after surgical fixation, surgical complications and patients’ functional outcome scores were recorded. The method of anaesthesia and any anaesthesia-related complications were also included. Results: There were 76 superelderly patients who underwent surgical fixation of their distal radius fractures identified from our institution’s prospective database from 2009 to 2016. Overall there were good functional outcome scores. The DASH scores at 3 months and 6 months were 17 and 10 respectively. Furthermore, the mean time to fracture union in our population was 47 days (approximately 7 weeks). There were only 2 post-operative surgical complications but no anaesthesia-related complications. Conclusions: Surgical fixation of distal radius fractures in appropriately selected patients in the superelderly population yields good functional outcomes.

scholarly journals The Importance of the Palmar Lunate Facet in the Treatment of Distal Radius Fractures

2016 ◽  
Vol 6 (1) ◽  
pp. 56-60
Author(s):  
Alexander J Lampley ◽  
Priyesh D Patel ◽  
Riikka EK Nomides ◽  
Suhail K Mithani
Keyword(s):  
Functional Outcome ◽  
Distal Radius Fracture ◽  
Distal Radius ◽  
Functional Outcomes ◽  
Distal Radius Fractures ◽  
Radius Fracture ◽  
Radius Fractures ◽  
Anatomical Reduction ◽  
Radiographic Measurements ◽  
Outcome Scores

ABSTRACT Background While there have been multiple studies published that have stressed the importance of restoring various different radiographic parameters to improve functional outcome scores, there is no consensus on the parameter that correlates most with patients’ functional outcomes. We hypothesize that obtaining near anatomical reduction of the palmar lunate facet is critical to improving functional outcome scores. The purpose of this study is to determine the effects of reduction and stabilization of the palmar lunate facet on functional outcomes in patients with intra-articular distal radius fracture. Materials and methods We prospectively collected clinical examination data, radiographic measurements, and functional outcome scores on 157 patients who were treated operatively for multifragmentary intra-articular fractures of the distal radius (AO Type C3) between 1996 and 2006. Prospective data were acquired at 3, 6 months, and 1 year postsurgical intervention in clinical follow-up. Based on radiographic measurements, patients were designated into a nondisplaced palmar lunate facet group and a displaced palmar lunate facet group. Clinical and functional outcomes were then compared between the groups. Results Patients without displacement had a significantly higher value of wrist extension and forearm supination when compared with the patients with displacement. In addition, the Gartland and Werley score was significantly higher in patients with displacement of the palmar lunate facet. Conclusion This study demonstrates that patients with near anatomical reduction of the palmar lunate facet after surgical treatment of an intra-articular distal radius fracture had improved range of motion and better functional outcome scores compared with patients with residual displacement of the palmar lunate facet. Richard MJ, Lampley AJ, Patel PD, Nomides REK, Mithani SK, Leversedge FJ, Ruch DS. The Importance of the Palmar Lunate Facet in the Treatment of Distal Radius Fractures. The Duke Orthop J 2016;6(1):56-60.

scholarly journals Functional outcome in patients with unstable distal radius fractures, volar locking plate versus external fixation: a meta-analysis

2013 ◽  
Vol 8 (2) ◽  
pp. 67-75 ◽  
Author(s):  
J. C. Goslings ◽  
Monique M. J. Walenkamp ◽  
Abdelali Bentohami ◽  
M. Suzan H. Beerekamp ◽  
Rolf W. Peters ◽  
...  
Keyword(s):  
Functional Outcome ◽  
External Fixation ◽  
Distal Radius ◽  
Locking Plate ◽  
Meta Analysis ◽  
Distal Radius Fractures ◽  
Plate Versus ◽  
Volar Locking Plate ◽  
Radius Fractures

Treatment of Distal Radius Fractures in Women Older than 80 Years: A Preliminary Report of Functional and Radiographic Outcomes after Open Reduction and Internal Fixation

2021 ◽  
Author(s):  
Lili E. Schindelar ◽  
Richard M. McEntee ◽  
Robert E. Gallivan ◽  
Brian Katt ◽  
Pedro K. Beredjiklian
Keyword(s):  
Internal Fixation ◽  
Distal Radius ◽  
Functional Outcomes ◽  
Open Reduction ◽  
The Elderly ◽  
Distal Radius Fractures ◽  
Implant Design ◽  
Complication Rates ◽  
Radius Fractures ◽  
Hardware Failures

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.

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

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

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

2016 ◽  
Vol 98 (7) ◽  
pp. 442-445 ◽  
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.

Dorsal Cortical Breaks in Volar Barton Distal Radius Fractures

Hand ◽  
2019 ◽  
pp. 155894471986264
Author(s):  
Michael C. Daly ◽  
Taylor A. Horst ◽  
Chaitanya S. Mudgal
Keyword(s):  
Distal Radius ◽  
Null Hypothesis ◽  
Independent Predictor ◽  
Distal Radius Fractures ◽  
Radius Fractures ◽  
Fracture Geometry ◽  
Plain Radiographs ◽  
Fracture Patterns ◽  
Discrete Fracture ◽  
Surgical Fixation

Background: Volar Barton fractures involve the volar articular margin of the distal radius with proximal and volar subluxation of the carpus. Although traditionally conceptualized as partial articular, some volar Barton fractures are complete articular injuries due to a dorsal cortical break in the distal radial metaphysis. While dorsal cortical breaks can affect surgical strategy, they may be difficult to identify on plain radiographs and their epidemiology remains poorly characterized. Some authors have hypothesized an association with osteoporosis; however, this hypothesis remains untested. To better characterize volar Barton fractures, we analyzed fracture geometry on pre-operative computed tomography (CT) scans to: (1) determine the frequency of a dorsal cortical break; and (2) test the null hypothesis that a dorsal cortical break is not associated with age or gender. Methods: We retrospectively reviewed adults with a volar Barton distal radius fracture and an available pre-operative CT who underwent surgical fixation. Using multivariable logistic regression, we assessed whether age or gender was an independent predictor of a dorsal cortical break. Results: Forty patients (mean age 52 years, 57% female) were identified. Including the shaft as a fragment, 32 (80%) had 3 or more discrete fracture fragments. Thirty patients (75%) had a dorsal cortical break. Dorsal cortical breaks were not associated with either age or gender ( P > 0.05). Conclusions: Most (75%) patients with volar Barton distal radius fractures had a dorsal cortical break. Dorsal cortical breaks were not statistically associated with age or gender, suggesting these fracture patterns may not be associated with osteoporosis as previously hypothesized.

scholarly journals Osteosynthesis of Unstable Fractures of Distal Radius with Volar Locking Plate

2013 ◽  
Vol 2 (1) ◽  
pp. 27-34
Author(s):  
RL Pradhan ◽  
S Sharma ◽  
BK Pandey ◽  
RR Manandhar ◽  
S Lakhey ◽  
...  
Keyword(s):  
Functional Outcome ◽  
Distal Radius ◽  
Locking Plate ◽  
Distal Radius Fractures ◽  
Volar Locking Plate ◽  
Radius Fractures ◽  
Volar Aspect ◽  
Clinical And Radiological Outcome ◽  
Clinical Scoring ◽  
Unstable Fractures

Background: Various surgical treatment methods are available for unstable distal radius fractures. Clinical and radiological outcome with volar locking plate has been very satisfactory. The purpose of this prospective study is to evaluate the results of the treatment of unstable fractures with the volar locking plate with regard to loss of reduction, functional outcome and complications. Methods: Unstable distal radius fractures were enrolled for the study from May 2008 until July 2010. All patients were treated with 3.5 mm distal radius volar locking plate and assessed by clinical and radiological examination. The clinical scoring chart modified by Cooney was used to evaluate the functional outcome. Results: Eighteen male and 12 female patients with the average age of 42.53 (range 30- 64years) were followed up for a period of 9 to 34 months (average.23 months). There were fourteen A3 fractures, nine C1 fractures, six C2 fractures, and one C3 fracture, whereas one had a Gustilo grade I open wound on the volar aspect. Seven of the fractures had associate fracture of the ulnar styloid. The functional outcome was excellent in 23 (76%), good in 6 (20%), fair in 1 (4%) and none had poor outcome. There were very few complications in our series. Conclusion: Unstable fractures of distal radius treated by open reduction with volar locking plate provides adequate fixation with no collapse in reduction and also have satisfactory functional outcome with minimal complications. DOI: http://dx.doi.org/10.3126/noaj.v2i1.8137 Nepal Orthopaedic Association Journal Vol.2(1) 2011: 27-34

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