Clinical Results of Distal Radius Intraarticular Comminuted Fractures in the Elderly: A Retrospective Comparative Analysis of Different Fixation Methods

Abstract

IntroductionDistal radius intraarticular fractures in the elderly population are likely to cause impaired clinical outcomes. Intraarticular fracture treatment in the literature is a debatable issue with mixed results. Here, we aimed to present a tertiary trauma center experience with plate fixation and K wire-assisted external fixator in elderlies over 60 years old. Material and methodsPatients who were diagnosed with an unstable intraarticular distal radius fracture and received surgical treatment with plate fixation or K wire-assisted external fixator between 2016 January and 2020 January were included in the study. Patients were evaluated retrospectively in terms of radiologic stability criteria and clinical outcomes. ResultsThere were 27 patients; 14 in the volar plate group (group 1) and 13 (group 2) in the external fixator group. The mean age was 64.2 (60-72) in group 1 and 67.7 (60-76) in group 2. The mean follow-up time was 31.6 (12-63) in group 1 and 28.8 (12-59) in group 2. The mean quick disabilities of the arm, shoulder, and hand (Q-DASH) score was 25.7 (5-75) in group 1 and 24.4 (10-87) in group 2. The mean patient-reported wrist evaluation (PRWE) was 27.1 (6-87) in group 1 and 31.4 (10-87) in group 2. There was no statistical difference between groups in terms of clinical scores, hospital stay, follow-up, and complications. (p>0.05). ConclusionAlthough open reduction and plate fixation and K wire-assisted external fixator are viable options for providing radiologic union, unsatisfactory clinical outcomes were maintained independently of the fixation method in elderly patients.

Surgical options for distal radius fractures in elderly patients over 65 years old: A comparison of external fixation and volar locking plate

“…After 6 weeks of external xation, fracture healing was assessed by X-ray, and after good fracture healing, the external xation frame was removed for systematic functional exercises. In previous reports on elderly patients with DRF, especially those with osteoporosis, the use of external xation had a poorer effect on maintaining radial length and a higher risk of pin loosening [21,22]. However, no pin loosening complications occurred in any of the EF group patients in this study.…”

Complications after volar plate synthesis for distal radius fractures

“…After the removal of duplicates, and screening of the titles, abstracts, and full texts, 112 articles were included in the systematic review ( Fig. 1 ) ( 6 , 10 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , ...…”

“…After the removal of duplicates, and screening of the titles, abstracts, and full texts, 112 articles were included in the systematic review (Fig. 1) (6,10,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51,52,53,54,55,56,57,58,59,60,61,62,63,64,65,66,67,…”

Surgical options for distal radius fractures of type C in elderly patients over 65 years old: a comparison of external fixation with Kirschner wires and volar locking plate

“…After 6 weeks of external fixation, fracture healing was assessed by X-ray, and after good fracture healing, the external fixation frame was removed for systematic functional exercises. In previous reports on elderly patients with DRF, especially those with osteoporosis, the use of external fixation had a poorer effect on maintaining radial length and a higher risk of pin loosening [ 22 , 23 ]. However, no pin loosening complications occurred in any of the EF group patients in this study.…”