Complications Associated With Operative Versus Nonsurgical Treatment of Distal Radius Fractures in Patients Aged 65 Years and Older

Lutz, Kristina; Yeoh, Kwan M.; MacDermid, Joy C.; Symonette, Caitlin; Grewal, Ruby

doi:10.1016/j.jhsa.2014.04.018

Cited by 110 publications

(98 citation statements)

References 9 publications

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“…[30] However, Lutz K et al found that elderly patients with distal radius fractures who underwent surgery had higher rates of complication than those nonsurgically treated. [31] Approximately 2% of patients sustained complication within 30 days following open reduction and internal fixation. [32] Nevertheless, results of the present meta-analysis suggested that there were no significant differences in complication rates between the internal fixation groups and the conservative treatment groups.…”

Section: Discussionmentioning

confidence: 99%

Internal fixation versus conservative treatment for displaced distal radius fractures: a meta-analysis of randomised controlled trials

Yu¹

2015

Ulus Travma Acil Cerrahi Derg

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Section: Discussionmentioning

confidence: 99%

Internal fixation versus conservative treatment for displaced distal radius fractures: a meta-analysis of randomised controlled trials

Yu¹

2015

Ulus Travma Acil Cerrahi Derg

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“…Although bone heals naturally, closed reduction can minimize the risk of infection, which is a rare but possible complication using surgical treatment. 7 Closed reduction is also commonly used in the treatment of displaced extra-articular fractures by immobilizing the region to limit injury to the soft tissues, tendons, and nerves caused by the displaced bone fragments. 7,8 Healing time is neither increased nor decreased in closed reduction, but long periods of immobilization may exacerbate stiffness and increase the risk of developing osteopenia.…”

Section: Introductionmentioning

confidence: 99%

“…12 Moreover, these percutaneously exposed hardware can be cumbersome to care for and have increased risk of infection. 7,12 The osteoporotic bone commonly seen in elderly patients further complicates the treatment course and makes those options less ideal. Interestingly, outcomes following both surgical and nonsurgical treatment approaches after a year have shown no significant difference.…”

Section: Introductionmentioning

confidence: 99%

Distal Radius Fracture Outcomes and Rehabilitation

Ikpeze

Smith

Lee

et al. 2016

Geriatr Orthop Surg Rehabil

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Distal radius fractures account for nearly 1 of every 5 fractures in individuals aged 65 or older. Moreover, increased susceptibility to vertebral and hip fractures has been documented in patients a year after suffering a distal radius fracture. Although women are more susceptible to hip fractures, men experience a higher mortality rate in the 7 years following a distal radius fracture. Traditional approaches to distal radius fractures have included both surgical and nonsurgical treatments, with predominant complaints involving weakness, stiffness, and pain. Nonsurgical approaches include immobilization with or without reduction, whereas surgical treatments include dorsal spanning bridge plates, percutaneous pinning, external fixation, and volar plate fixation. The nature of the fracture will determine the best treatment option, and surgeons employ a multifactorial treatment approach that includes the patient’s age, nature of injury, joint involvement, and displacement among other factors. Historically, closed reduction and percutaneous pinning have been the most popular approaches. However, volar plate fixation is quickly becoming a popular option as it minimizes tendon irritation, reduces immobilization time, and decreases risk of complication. The goal of treatment is to restore mobility, reduce pain, and improve functional outcomes following rehabilitation. The aim of this review is to summarize the most common treatments and importance of early referral to hand therapy to improve functional outcomes.

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“…Distal radius fractures (DRFs) are the most common fractures of the upper extremity. Although favorable clinical outcomes have been reported after conservative treatment with cast immobilization in elderly patients, patients with residual deformity frequently complain of wrist pain, reduced grip strength, late median nerve neuropathy, and restricted range of motion (ROM) …”

mentioning

confidence: 99%

Three‐Dimensional In Vivo Analysis of Malunited Distal Radius Fractures With Restricted Forearm Rotation

Abe

Oka

Miyamura

et al. 2019

Journal Orthopaedic Research

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Malunited distal radius fractures (DRFs) occasionally restrict forearm rotation, but the underlying pathology remains unclear. We aimed to elucidate the mechanism of rotational restriction by retrospective analysis of 23 patients with unilateral malunited DRFs who presented restricted forearm rotation. We conducted computed tomography during forearm rotation on both sides. Three-dimensional (3D) bone surface models of the forearm were created, and 3D deformity of the distal radius, translation of the distal radius relative to the ulna, distal radioulnar joint (DRUJ) contact area, and estimated path length (EPL) of distal radioulnar ligaments (DRUL) during forearm rotation were evaluated. In total, 18 patients had dorsal angular deformities (DA group) and five had volar angular deformities (VA group). In the DA group, the closest point between the distal radius and ulna on DRUJ was displaced to the volar side during supination and pronation (p < 0.001); DRUJ contact area was not significantly different between the DA and normal groups. In bone-ligament model simulation, the EPL of dorsal DRUL was longer in the DA group than in the normal group (p < 0.001); opposite phenomena were observed in the VA group. In the DA group, translation of the distal radius in a volar direction relative to the ulna during pronation was impaired presumably due to dorsal DRUL tightness. Anatomical normal reduction of the distal radius by corrective osteotomy may improve forearm rotation by improving triangular fibrocartilage complex tightness and normalizing translation of the distal radius relative to the ulna.

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Complications Associated With Operative Versus Nonsurgical Treatment of Distal Radius Fractures in Patients Aged 65 Years and Older

Cited by 110 publications

References 9 publications

Internal fixation versus conservative treatment for displaced distal radius fractures: a meta-analysis of randomised controlled trials

Internal fixation versus conservative treatment for displaced distal radius fractures: a meta-analysis of randomised controlled trials

Distal Radius Fracture Outcomes and Rehabilitation

Three‐Dimensional In Vivo Analysis of Malunited Distal Radius Fractures With Restricted Forearm Rotation

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