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[The results of non-surgical treatment for unstable distal radius fractures in elderly patients].

Abstract：

OBJECTIVES:This study was designed to evaluate anatomical and functional results of non-surgical treatment for unstable distal radius fractures in the elderly. METHODS:Twenty-nine patients (7 males, 22 females; mean age 72+/-2 years) aged = or > 65 years were treated with closed reduction and short-arm circular casting for unstable distal radius fractures. According to the AO classification, all patients had type C fractures. Anatomical and functional results were assessed using the Stewart criteria and Q-DASH (Quick-Disability of Arm, Shoulder and Hand) questionnaire, respectively. Bone mineral density measurements were performed. Grip strength and wrist range of motion were measured in comparison to the unaffected side. The mean follow-up was eight months (range 6 to 12 months). RESULTS:Union was achieved in all fractures within a mean of 4+/-1 weeks. Bone mineral density measurements showed osteoporosis in 22 patients (75.9%), and 26 patients (89.7%) had regional osteoporosis in cortical width measurements. After treatment, radiographic measurements showed the following: radius tilt angle +5.6+/-5.4 degrees , inclination angle 17+/-4.6 degrees , radial height 9+/-2.3 mm, and positive ulnar variance 2.8+/-2 mm. Five patients (17.2%) exhibited an articular step-off of less than 1 mm on the radial surface. According to the Stewart criteria, the results were good in 15 patients (51.7%), moderate in 12 patients (41.4%), and poor in two patients (6.9%). The mean Q-DASH score was 38+/-19.2 at three months, and 23+/-2.4 at final follow-up. Grip strength, extension/flexion, and pronation/supination were measured as 57.3+/-12.5%, 52+/-14%, and 75+/-16% of the unaffected side, respectively. Complications were seen in 11 patients (37.9%). Three patients (10.3%) developed malunion which required corrective osteotomy. CONCLUSION:Unstable distal radius fractures can be treated with closed reduction and cast application in low-demand elderly patients to avoid risks and complications of surgery.

journal_name

Acta Orthop Traumatol Turc

journal_title

Acta orthopaedica et traumatologica turcica

authors

Kilic A,Ozkaya U,Kabukcuoglu Y,Sokucu S,Basilgan S

doi

10.3944/AOTT.2009.229

subject

Has Abstract

pub_date

2009-05-01 00:00:00

pages

229-34

issue

3

eissn

1017-995X

issn

2589-1294

journal_volume

43

pub_type

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