333 Management of Distal Radius Fractures During The COVID-19 Crisis

Abstract

Introduction Distal radius fractures are common. Treatment depends on a multitude of factors including the pattern / displacement of the fracture, patient age, pre-morbid function, and surgeon preference. We aim to investigate the effect of the pandemic on the management and short-term outcomes of patients with DRF’s. Method Retrospective review of all adult DRF’s two months before and after BOA released emergency standards on trauma management. The primary outcome measure was the proportion of patients managed non-operatively before and during COVID-19. Data extracted: demographics, comorbidities, cognitive baseline, treatment, and follow-up. Radiographs were reviewed for displacement [dorsal tilt (>10o), ulnar variance (>3mm), intra-articular step (>2mm)]. Results Pre-COVID (n = 29), COVID (n = 35). Characteristics were comparable in terms of median age (66 and 72 years, p = 0.41), %aged ≤65 (48% and 37%, p = 0.37), dominant side fracture (36% and 40%, p = 0.52), presence ≥ 2 co-morbidities (41% and 43%, p = 0.91). More patients were managed non-operatively during COVID (86% vs. 69%, p = 0.11), 2 of whom had unstable fracture pattern and developed malunion, compared to none in pre-COVID period. Conclusions Management of DRF’s remains a controversial topic, particularly in age <65 years. Long term follow up of patients with significant fracture displacement managed conservatively during COVID pandemic could help guide future practice.