Fractures of the Distal End of Radius in Elderly Patients: A Comparative Study of Anatomical and Functional Results

Abstract

The functional and anatomical results of distal end of radius fractures with severe displacement in 22 elderly patients are reviewed in this retrospective study. The mean age of the patients was 69.4 years (range, 60-88 years) and the mean follow-up period was 24 months (range, 12-53 months). According to the sum of demerit points (Saito, 1983), the latest follow-up functional end results were excellent in 64% of fractures and good in 36%. As for the anatomical results at follow-up, the average radial tilt was 20.7 degrees, ulnar variance was 4.0 mm, and palmar tilt was -2.7 degrees respectively. Though most of the patients had satisfactory outcome and the functional results did not correlate with the radiographic evidence of minor deformities, the functional results of the patients with radial shortening of 6 mm or over were poor. Furthermore, the grip power was the most significant factor related to subjective evaluation and did not improve significantly in patients with the non-dominant hand injured.

A Comparative Study of Clinical and Radiological Outcomes of Dorsally Angulated, Unstable Distal Radius Fractures in Elderly Patients: Intrafocal Pinning Versus Volar Locking Plating

“…26,27 Aro and Koivunen 26 reported poor results in 4% of patients with UVՅ3 mm, 25% at UV more than 3 mm but less than 5 mm, and 31% at UVՆ5 mm. We have to avoid radial shortening with UV more than 3 mm to achieve good clinical results after distal radius fracture.…”

Distal Radius Fracture Management in Elderly Patients: A Literature Review

“…Although traditionally immobilized with a cast, this management is being revisited as patients are living longer and more active lives. Voigt [41] Orbay [44] Ochman [29] McQueen [23] McQueen [10] Linhart [37] Leone [11] Kwasny [26] Kock [45] Keller [43] Jupiter [47] Jubel [50] Hegeman [21] Fujii [22] Board [24] Beumer [12] Beharrie [49] FIGURE 3: Study scoring, retrospective trials and case series. First author and reference number are provided for each study.…”

“…Minor deformities of radial shortening Ͻ4 mm and dorsal tilt Ͻ3°, however, did not greatly affect functional outcome. 22 Another study shows that a distal radius malunion of more than 10°dorsal angulation along with 2 mm radial shortening resulted in a greater likelihood of developing a weak, stiff, and painful wrist in patients with a mean age of 69 years. 23 A retrospective study comparing manipulation and plaster immobilization with the Kapandji K-wire method reported a correlation between functional results and radiographic fracture appearance.…”

Correlation between functional outcome and radiological parameters of healed fracture of distal radius after closed reduction with plaster or percutaneous fixation

“…21 Fujii et al determined that fractures that had healed with 6 mm or more of radial shortening were likely to have a poor functional outcome. 22 More than 10 of dorsal tilt leads to a dorsal carpal shift with compressive forces, which causes pain and insecurity with gripping. This has been associated with increased difficulty with everyday activities and work.…”