Background Distal radius fractures (DRFs) constitute 15–21% of all fractures. There are no detailed data on the possible changes in the epidemiology and treatment of DRFs in children and adults during the Covid pandemic. The purpose of our study was a comprehensive assessment of the impact of the COVID-19 pandemic on distal radius fractures (DRF) epidemiology, including both children and adults and various fracture fixation methods in two large trauma centers in Poland. Methods This study compared the medical data on the treatment of distal radius fractures in Poland in two periods: the period of the COVID-19 pandemic (from March 15 to October 15, 2020) and the corresponding period prior to the pandemic (from March 15 to October 15, 2019). We assessed detailed data from two trauma centers for pediatric and adult patients. Outpatients seeking medical attention at emergency departments and inpatients undergoing surgery at trauma-orthopedic wards were evaluated. We compared epidemiological data, demographic data, treatment type, and hospital stay duration. Results The total number of patients hospitalized due to DRF during the pandemic was 180, it was 15.1% lower than that from the pre-COVID-19 pandemic period (212). In the case of adult patients, the total number of those hospitalized during the pandemic decreased significantly (by 22%) from 132 to 103 patients. Analysis of the individual treatment methods revealed that the number of adults who underwent conservative treatment was considerably (by 30.3%) significantly lower in the period of the COVID-19 pandemic, from 119 to 83 patients. Compared to 13 patients from the pre-pandemic period, the number of surgically treated adults statistically increased to 20 patients (by 53.8%). Our analyses showed hospitalizations of surgically treated adults to be shorter by 12.7% during the pandemic, with the corresponding hospitalizations of surgically treated pediatric patients to be shorter by11.5%. Conclusions Our study showed a significant impact of the COVID-19 pandemic on the epidemiology and treatment of DRFs in children and adults. We found decreased numbers of pediatric and adult patients with DRFs during the COVID-19 pandemic. The pandemic caused an increase in the number of children and significantly increase adults undergoing surgical treatment for DRFs, a decrease in mean patient age, shorter significantly length of hospital stay, and an increased number of men with DRFs.

Background: The purpose of our study was to analyze kinematic parameters following pilon fracture treatment with the Ilizarov method. Methods: Our study assessed kinematic parameters of gait in 23 patients with pilon fractures treated with the Ilizarov method. Patients had completed their treatment 24–48 months prior to measurements. The range-of-motion values in the non-operated limb (NOL) and operated limb (OL) were compared. Kinematic parameters were measured using the Noraxon MyoMOTION System. Results: We observed no significant differences in hip flexion, hip abduction, or knee flection between the OLs and NOLs in patients after treatment with the Ilizarov method. We observed significant differences in the ranges of ankle dorsiflexion, inversion, and abduction (p < 0.001; p < 0.001; p < 0.003, respectively) between the OLs and the NOLs. Conclusion: Following pilon fracture treatment with the Ilizarov method, we observed no differences in terms of knee or hip joint mobility between the OL and the NOL, whereas the range of motion in the ankle joint of the OL was significantly limited. The treatment of pilon fractures with the Ilizarov method does not ensure the complete normalization of ankle joint kinematic parameters. Therefore, intense personalized rehabilitation of the ankle joint is recommended.

Background. The optimal duration of cast immobilization following distal radius fractures (DRFs) in elderly patients has not been established. Objectives.To assess the functional and radiological parameters following DRF treatment in elderly patients using 2 different periods of cast immobilization. Materials and methods.We assessed 50 patients (33 women and 17 men). The mean age at the beginning of treatment was 71 years. The mean duration of follow-up was 1 year and 3 months. One subgroup (n = 26) included patients treated with a cast for 4 weeks, whereas the other subgroup (n = 24) included patients treated with a cast for 6 weeks. The following measures were assessed: union rate, radial inclination, volar tilt, radial height, Visual Analogue Scale (VAS) pain score, Mayo Wrist Score, and VAS activity score.Results. The mean volar tilt was 9. 13° in the group treated with a cast for 4 weeks and 3.29° in the group treated with a cast for 6 weeks (p = 0.043). There were no differences between the groups in terms of any other functional or radiological parameters. Conclusions.The VAS pain score, Mayo Wrist Score and VAS activity score were similar between the 2 study groups. The greatest volar tilt angle was observed after 6 weeks of cast immobilization. The study groups showed no significant differences in terms of radial inclination, union rate, radial height, or bone union. A period of 4 weeks of cast treatment was sufficient for elderly patients with DRFs.

Background: There is no consensus among orthopedic surgeons as to the required period of cast immobilization in distal radius fractures in elderly patients. The purpose of this study was to assess muscle strength and range of motion symmetry in elderly patients after distal radius fractures with different periods of cast immobilization. Methods: This study evaluated 50 patients (33 women and 17 men), aged over 65 years, after cast immobilization treatment for distal radius fracture. The mean age at the beginning of treatment was 71 years. The mean duration of follow-up was 1 year and 3 months. The first subgroup (n = 24) comprised the patients whose fractures had been immobilized in a cast for 6 weeks, another subgroup (n = 26) comprised the patients with 4-week cast immobilization. We assessed: 1) muscle strength, 2) range of motion. Results: The mean grip strength in the treated limb was 71% and 81% of that in the healthy limb in the groups with 4-week and 6-week cast immobilization, respectively (p = 0.0432). The study groups showed no differences in the mean grip strength in the treated limbs or the mean grip strength in the healthy limbs. The mean treated limb flexion was 62° and 75° in the 4-week and 6-week immobilization groups, respectively (p = 0.025). The evaluated groups showed no differences in terms of any other range of motion parameters. The grip strength and range of motion values were significantly lower in the treated limb than in the healthy limb in both evaluated groups. Only the values of wrist radial deviation in the 6-week cast immobilization group showed no differences between the treated and healthy limbs. Conclusion: Higher values of injured limb muscle strength and greater mean range of wrist flexion were achieved in the 6-week subgroup. Neither of the evaluated groups achieved a symmetry of muscle strength or range of motion after treatment. Full limb function did not return in any of the elderly distal radius fracture patients irrespective of cast immobilization duration.

No abstract

Background: Distal radius fractures pose a serious problem due to their high incidence and can be treated with various methods. No specific distal radius fracture treatment is acknowledged to be the gold standard by orthopedic surgeons. The aim of study was to conduct a comprehensive radiographic assessment of treatment outcomes in patients with distal radius fractures following various types of stabilization in elderly patients. Methods: We retrospectively assessed 122patients who underwent treatment for distal radial fracture in the years 2017and2018.There were three study groups: closed reduction with K-wire fixation (37patients),open reduction with volar plate fixation (42 patients),and closed reduction with cast immobilization (43patients).The mean age at the beginning of treatment was 73years.The mean follow-up period was 2 years and 7months.The following radiological parameters were evaluated: union rate, time to union, time of fracture immobilization, fracture stabilization failure, and the development of adjacent-joint arthritis. Results: There were no significant differences between the study groups in terms of union rate, time to union, and the development of adjacent-joint arthritis. After treatment, the lowest rates of posttraumatic intercarpal and carpometacarpal arthritis and the lowest rates of fracture stabilization failure in our study were observed in the plaster-cast group. Volar plate fixation was associated with the shortest duration of fracture stabilization. In comparison to the status from before treatment, all study groups showed increased rates of intercarpal and carpometacarpal arthritis after treatment. Conclusions: Our radiographic assessments demonstrated similar outcomes, regardless of the stabilization method. In treating distal radius fractures, we achieved good radiographic treatment outcomes irrespective of the fracture stabilization method used.

Bacground: The purpose of our study was a comprehensive assessment of the impact of theCOVID-19 pandemic on distal radius fractures(DRF)epidemiology,including both children and adults and various fracture fixation methods in two large trauma centers in Poland.Methods: This study compared the data on the treatment of distal radius fractures in Poland in two periods:the period of the COVID-19 pandemic and the corresponding period prior to the pandemic.We assessed detailed data from two trauma centers for pediatric and adult patients.We compared epidemiological data,demographic data,treatment type,and hospital stay duration.Results: The total number of patients hospitalized due to DRF during the pandemic was 15.1% lower than that from the pre-COVID-19 pandemic period.In the case of adult patients, the total number of those hospitalized during the pandemic decreased significantly(by 22%) from132 to103patients.Analysis of the individual treatment methods revealed that the number of adults who underwent conservative treatment was considerably(by 30.3%)significantly lower in the period of the COVID-19 pandemic.Compared to the figures from the pre-pandemic period,the number of surgically treated adults was significantly higher(by 53.8%).Our analyses showed hospitalizations of surgically treated adults to be shorter by 12.7%during the pandemic,with the corresponding hospitalizations of surgically treated pediatric patients to be shorter by11.5%.Conclusions: Our study showed decreased numbers of pediatric and adult patients with DRFs during the COVID-19 pandemic.The pandemic caused an increase in the number of children and significantly increase adults undergoing surgical treatment for DRFs, a decrease in mean patient age,shorter significantly durations of hospital stay, and an increased number of men with DRFs.