Skeletally Mature Patients with Bilateral Distal Radius Fractures Have More Associated Injuries

Abstract

Bilateral distal radius fractures are rare injuries and only a handful of case reports exist. Understanding the demographic variables and associated injuries in patients with these fractures may improve awareness and treatment of concomitant injuries. We determined the differences in mode of trauma and associated injuries between skeletally mature and skeletally immature patients with bilateral distal radius fractures. We retrospectively reviewed the records of 93 patients with bilateral distal radius fractures. We compared demographic data, fracture patterns, mode of injury, treatment modality, and associated injuries for skeletally mature and immature patients. The mean age of all patients sustaining a bilateral injury was 22.5 years and 61 (71%) were male. Of the 51 (55%) skeletally immature patients, 37 (73%) were male, and 44 (86%) sustained a low-energy mechanism of injury. Of the 42 (45%) skeletally mature patients, 29 (69%) were male, and 37 (88%) sustained a high-energy mechanism of injury. Skeletally mature patients had a 38% rate of associated injuries versus 4% found in skeletally immature patients. Skeletally mature patients sustained bilateral distal radius fractures through higher-energy mechanisms and presented with more frequent associated injuries compared with the skeletally immature patients.

Analysis of variation in the surgical treatment of patients with distal radial fractures in the Netherlands

“…For the purpose of our analyses, we assumed that the number of procedures (both conservative and surgical treatment) equalled the number of patients. This assumption does not account for patients with bilateral fractures; however, from experience we expect this number to be negligible and estimate that it is not more than 50 patients each year (Ehsan and Stevanovic, 2010).…”

Outcomes of Open Reduction and Internal Fixation of Bilateral Fractures of the Distal Radius

“…In an epidemiological study of 93 patients, Ehsan and Stevanovic noted that most bilateral DRFs in skeletally immature patients resulted from low-energy trauma and were managed nonoperatively. 10 Conversely, this injury to skeletally mature individuals more often occurred due to high-energy trauma and was treated operatively. Bilateral DRFs in skeletally mature patients were associated with additional injuries 38% of the time versus 4% in their skeletally immature counterparts.…”

“…The current available literature comprises primarily a handful of case reports, and therefore it lacks any outcomes or complication data. [5][6][7][8][9][10] We present a series of 10 consecutive cases of bilateral DRF treated with open reduction and internal fixation (ORIF) at our institution. We evaluated functional and radiographic outcomes as well as incidence of complications.…”

Functional and radiological outcome of unstable distal radius fracture treated by conservative or volar buttress plate

“…[9,10] . Despite the large body of literature on the subject, results of the non-operative management of distal radius fractures remain conflicted.…”