Arthroscopically Assisted Reduction With Volar Plating or External Fixation for Displaced Intra-Articular Fractures of the Distal Radius in the Elderly Patients

Abstract

Twenty-eight patients older than 70 years with AO type C fracture of the distal radius were treated with arthroscopically assisted reduction combined with volar plating or external fixation. The patients were followed up for an average of 24.9 +/- 16.1 months. The average score was 80.1 +/- 10.5 according to the modified system of Green and O'Brien. Eight patients had an excellent result, 11 had a good result, seven had a fair result, and two had a poor result. Twenty-three patients were able to return to their previous activities level or occupation without any restriction. On the basis of these results, we concluded that arthroscopically assisted reduction combined with volar plating or external fixation is one of the useful options for the treatment of a displaced intra-articular fracture of the distal radius in elderly patients who are physiologically young or active.

Prospective Randomized Study Comparing the External Fixator and Volar Locking Plate in Intraarticular Distal Radius Fractures: Which Is Better?

“…However, we observed a significant increase in the individual scores of both groups over the course of physiotherapy by the six months' follow-up and more so in the external fixator group so it was on par with the volar plating group in total score according to the Green O'Brien system and the difference in both groups is statistically insignificant at the six months' follow-up. Hattori Y et al also did not find any statistically significant correlation among groups treated with either plating or external fixation and evaluated using Green & O'Brien scoring [23]. Similar results were seen in a study conducted by Germaine GQ et al, where the Green & O' Brien score of plating and the fixator group at 12 months was 73 and 74 (p-value=0.76), respectively, and at 24 months were 81 and 80 (p-value=0.85), respectively [24].…”

Contribution of arthroscopy to the management of intra-articular distal radius fractures: Knowledge update based on a systematic 10-year literature review

“…The system used to classify the fractures varied across studies, with the AO classification [18] being used most often and the classifications devised by Frikman [8,19] and Castaing [9] less often. The internal fixation methods varied also.…”

Apport de l’arthroscopie dans la prise en charge des fractures articulaires du radius distal. État actuel des connaissances à propos d’une revue systématique de 10 ans de la littérature

“…L'ensemble des études utilisaient différentes classifications. La classification AO [18] des fractures était la plus utilisée, mais nous retrouvions également la classification de Frikman [8,19] et Castaing [9]. Les moyens d'ostéosynthèses employés étaient variables en fonction des études.…”

“…Les moyens d'ostéosynthèses employés étaient variables en fonction des études. Elles pouvaient utiliser le brochage seul [3,9], combiner brochage et fixation externe [4,8] plaque antérieure verrouillée [5,6,10,12,13,[15][16][17] ou plusieurs moyens en fonction du type de fracture [19,11,7]. Pour analyser l'apport de l'arthroscopie, les principaux critères de jugements mesurés étaient la comparaison de la marche d'escalier et l'écart interfragmentaire entre 2 groupes de patients pour les études comparatives [3][4][5][6][7].…”