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

Abstract

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.

Management of distal radius fractures in the emergency department: A long‐term functional outcome measure study with the Disabilities of Arm, Shoulder and Hand (DASH) scores

“…Multiple linear regression (MLR) models were adopted for multivariate analysis of the DASH scores to identify the significant predictor variables. From the literature, we found that age, sex, ethnicity, type of fractures, clinicians involved, type of anaesthetic techniques and POP used affected the outcome of DRF. Therefore, we took those variables into consideration during developing MLR models.…”

Re-fracture of Distal Radius and Hardware Repair in the Setting of Trauma

“…The introduction of the fixed angle locking-plate allowed for rigid stabilizer without additional intervention or bone graft. 18 This treatment type has shown positive outcomes in both the twenty to forty year old age groups and especially in the greater than sixty year old age group. 19 …”

Volar locking plate fixation for distal radius fractures: Does age affect outcome?

“…Subjective and composite scores in this study agree with previous studies. 27 Some of the differences between the groups could be attributed to the higher ratio of AO/OTA type C fractures in the younger age group. However, the results of this study can be supported by biomechanical research, which demonstrated that the VLP device was efficient in the restoration of the normal axial force alignment without the reliance on screw engagement into the bone due to the nature of the screws, which mediate better locking mechanism into osteoporotic bone.…”

“…23 For unstable distal radial fractures, closed reduction has been reported to compromise functional return and result in malunion in up to 50%. 24,21,25 Treatment options include percutaneous wiring, reported as ineffective in osteoporotic bone, 26,27 dorsal plate fixation, which can lead to attrition ruptures of extensor tendons, 28 and external fixation, which carries the risk of pin tract infection and wrist stiffness. 29 One option for treating these complex fractures is by open reduction and internal fixation.…”