Epidemiology of Distal Radius Fixations and Functional Outcomes in the Superelderly Population

Abstract

Background: Superelderly patients (defined as 80 years old and older) account for 18% of all distal radius fractures in our institution and this number is increasing with the ageing population. When faced with the option of surgery, patients in this age group have concerns with regards to the long term outcomes including functional outcomes and the time to fracture union. Therefore, the aim of this study was to evaluate the functional outcomes in this specific population. Methods: Patient selection for surgery was determined by the fracture stability, the patient’s premorbid function and underlying comorbidities. Post operatively, the time to fracture union after surgical fixation, surgical complications and patients’ functional outcome scores were recorded. The method of anaesthesia and any anaesthesia-related complications were also included. Results: There were 76 superelderly patients who underwent surgical fixation of their distal radius fractures identified from our institution’s prospective database from 2009 to 2016. Overall there were good functional outcome scores. The DASH scores at 3 months and 6 months were 17 and 10 respectively. Furthermore, the mean time to fracture union in our population was 47 days (approximately 7 weeks). There were only 2 post-operative surgical complications but no anaesthesia-related complications. Conclusions: Surgical fixation of distal radius fractures in appropriately selected patients in the superelderly population yields good functional outcomes.

Perioperative Morbidities in Distal Radius Fractures Treated Using Locking Plates in the Super-Elderly Population: A Retrospective Study

“…The complication rate varies widely in the literature. 16 , 17 , 18 , 19 , 20 Our complication rate appears high compared with the 3% rate described by Heng et al, 18 who observed patients aged over 80 years. However, their study did not include minor complications.…”

“… 2 This female predominance found in literature matches our results. 18 , 29 , 30 , 31 Moreover, distal radius fractures are often the result of a low-energy fall on an outstretched wrist. 3 , 32 Older independent patients in good cognitive health seem to be at higher risk of sustaining a distal radius fracture as they still have the reflex to put their arm forward when they fall.…”

Distal radius fractures in the superelderly: an observational study of 8486 cases from the Swedish fracture register

“…A retrospective study of 76 superelderly patients treated with a volar plate found that surgical fixation can yield a good functional outcome [ 40 ]. Other studies have found no significant relationship between malalignment after a DRF and functional outcome in older patients [ 8 , 41 ].…”

Treatment of Distal Radius Fractures in Women Older than 80 Years: A Preliminary Report of Functional and Radiographic Outcomes after Open Reduction and Internal Fixation

“…[12][13][14] One study assessing this patient group after surgical fixation of distal radius fractures found that ORIF yields good functional outcomes and a low complication rate. 14 The purpose of our study was to evaluate the operative treatment of distal radius fractures in patients older than 80 years to determine functional outcomes and complication rates. We hypothesize that patients older than 80 years with distal radius fractures treated with ORIF will have good functional outcomes and low complication rates.…”

“…6,7 Most of the current data on surgical management of distal radius fractures in the elderly focus on patients older than 60 years; however, there is a lack of data on patients older than 80 years. [12][13][14] One study assessing this patient group after surgical fixation of distal radius fractures found that ORIF yields good functional outcomes and a low complication rate. 14 The purpose of our study was to evaluate the operative treatment of distal radius fractures in patients older than 80 years to determine functional outcomes and complication rates.…”