Distal Radial Fractures in the Elderly: Operative Compared with Nonoperative Treatment

Egol, Kenneth A.; Walsh, Michael; Romo-Cardoso, S.; Dorsky, Seth; Paksima, Nader

doi:10.2106/jbjs.i.00968

Cited by 197 publications

(192 citation statements)

References 17 publications

Supporting

Mentioning

168

Contrasting

Unclassified

Order By: Relevance

“…Despite these reports about good radiological and functional results Egol et al 33 retrospectively compared outcomes for patients over the age of 65 years with a displaced DRF, who were treated surgically (plate fixation or EF) or nonsurgically (cast fixation). At 24 weeks, patients who underwent surgery had better wrist extension than those treated nonsurgically.…”

Section: Open Reduction and Volar Locking Plate Fixationmentioning

confidence: 99%

Aspects of Current Management of Distal Radius Fractures in the Elderly Individuals

Arora

Gabl

Erhart

et al. 2011

Geriatr Orthop Surg Rehabil

View full text Add to dashboard Cite

Diatal radius fractures (DRFs) are typical fractures of relatively fit persons with osteoporotic bone who remain active into older age. Traditionally, DRFs in older patients have been treated with closed reduction and cast immobilization. Considering the increasing life expectancy of the elderly population, appropriate management of these fractures is of growing importance. Decision making for surgical or nonsurgical approach to osteoporotic DRFs is difficult. These decisions are often made based on the data from treatments of much younger patients. The current literature concerning the treatment of DRFs in the elderly individuals is more controversial. Some investigators have recommended open reduction internal fixation (ORIF) as treatment for unstable DRFs in older patients, while others have suggested that elderly patients should be treated nonsurgically even if there is an unstable fracture situation because fracture reduction is not associated with functional outcomes as in younger patients. This article reviews the different treatment options for DRFs in the elderly individuals reported in the recent literature.

show abstract

Section: Open Reduction and Volar Locking Plate Fixationmentioning

confidence: 99%

Aspects of Current Management of Distal Radius Fractures in the Elderly Individuals

Arora

Gabl

Erhart

et al. 2011

Geriatr Orthop Surg Rehabil

View full text Add to dashboard Cite

show abstract

“…Some point out the importance to strive for an anatomical reduction and a postoperative stable situation enabling immediate active range of motion [9,10]. Others suggest that a worse radiographic outcome in conservatively treated patients does not limit functional recovery at one year [11]. After the introduction of the volar plate in the early 1990s locking plates are currently gaining popularity because of their high stability and improved fixation in osteoporotic bone [12,13].…”

Section: Introductionmentioning

confidence: 99%

Type C distal radial fractures treated with conventional AO plates: an easy and cost-saving solution in a locking plate era

Twigt

Bemelman

Lansink

et al. 2013

International Orthopaedics (SICOT)

View full text Add to dashboard Cite

Purpose C-type distal radial fractures remain challenging fractures. Currently locking plates are very popular because of their length preserving, stability. A considerable drawback is the high cost. Since 2003 we have been using mini AO plates (2.7 mm) as an alternative. We analysed our results and performed a cost analysis. Methods Retrospective analysis was performed of all patients operated upon between 2003 and 2008 for C type distal radius fractures. Reduction was achieved with mini AO plates, applied in a buttress fashion, with ligamentotaxis. Rehabilitation consisted of immediate mobilisation. Pre-and postoperative X-rays, operative results and patient charts were reviewed. Furthermore, we prospectively evaluated the functional results using VAS, DASH and Mayo wrist scores. Lastly, we assessed the implant costs and compared them to locking plates. Results Thirty-four patients were treated with a mean age of 49 years. Mean radial shortening improved 2 mm; dorsal and radial angulation improved 23 and 4°, respectively. At consolidation (eight weeks) the average radial shortening was 0.75 mm, a volar angulation of 3°, and 21°of radial angulation. Functional results were excellent, demonstrated by a mean VAS score less than 1, a DASH score of 12 and a Mayo wrist score of 87. Compared to locking plates, there was an overall reduction in material costs of 15,300 Euro.Conclusions Our technique has excellent biomechanical stability, enabling immediate functional rehabilitation, good anatomical and functional outcome with significantly lower costs.

show abstract

“…13 Egol et al demonstrated better outcomes in the open reduction and internal fixation group at 3 months but similar outcomes at six and twelve months after treatment. 14 In our study, one patient with type 4 fracture having radial collapse, volar tilt and bone loss due to comminution was operated by external fixator as a temporary stabilizer to maintain radial height, volar plating to buttress the fragment and bone grafting to fill the gap. Patient had an excellent score at 1 year follow up.…”

Section: Discussionmentioning

confidence: 96%

Comparison study for internal and external modes of fixation for fractures of distal end radius

Shah

et al. 2017

Int J Res Orthop

View full text Add to dashboard Cite

Background: Fractures of the distal radius continue to be one of the most common skeletal injuries. The methods which are commonly practiced are closed manipulation and plaster cast, pins and plaster, percutaneous pinning, external fixation and open reduction and internal fixation with or without bone graft. Surgeons are increasingly faced with the dilemma of when to consider operative management and when cast immobilization is the optimal treatment.Methods: 47 cases of distal end radius fractures were operated in the orthopedic department of a tertiary care centre. The purpose of the present study was to compare the results of external and internal fixation methods for the treatment of fractures of distal end of radius. Patients operated by external fixation were classified as Group A and those operated by internal fixation were classified as group B. Patients were classified according to AO Classification. Patients were followed at regular intervals depending on the case and time of operation and evaluated by Gartland and Werley score.Results: In our study, 29 patients were of extraarticular type, of which 86.20% had an excellent score and 18 patients were of intraarticular type, of which 83.33% had an excellent score. But when compared to groups A and B, the percentage of excellent score obtained in group B was more than that in group A in both extraarticular and intraarticular fractures. Yuan-kun et al did a study on intraarticular distal end radius fractures and evaluated the patients by Gartland and Werley point system, concluding that plating gives better results than external fixation supplemented by K wiring. Conclusions: We concluded that no method of fixation can be said superior to the other. Each method has fracture-specific indication. The results of open reduction and internal fixation can be better than external fixation in initial months, but in the long run, both the methods can have excellent score, provided the fixation is good and properly indicated.

show abstract

Distal Radial Fractures in the Elderly: Operative Compared with Nonoperative Treatment

Abstract: Therapeutic Level III. See Instructions to Authors for a complete description of levels of evidence.

Cited by 197 publications

References 17 publications

Aspects of Current Management of Distal Radius Fractures in the Elderly Individuals

Aspects of Current Management of Distal Radius Fractures in the Elderly Individuals

Type C distal radial fractures treated with conventional AO plates: an easy and cost-saving solution in a locking plate era

Comparison study for internal and external modes of fixation for fractures of distal end radius

Contact Info

Product

Resources

About