Winkelstabile Plattenosteosynthese am distalen Radius

The demographic development will result in an increase of up to 30 % of distal radius fractures. There are various therapy options but what is new? Conservative therapy: conservative therapy is reserved for stable fractures only. Osteosynthesis by K-wires: due to low biomechanical stability in older patients, insufficient functional and radiological results were achieved. External fixator: external fixators are used in compound and complex fractures and show better results than K-wire osteosynthesis. Angular stable plate osteosynthesis: with angular stable plates it is possible to achieve good results with complex fractures and they are currently the method of choice. Intramedullary osteosynthesis: intramedullary nails result in a faster functional improvement than angular stable plates but have limitations. New is that 90% of osteoporotic distal radial fractures are treated with angular stable plates which have shown good results in single study groups.

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Osteoporotische Frakturen des distalen Radius

Meiners

Jürgens

Mägerlein

et al. 2012

Chirurg

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Klinische Ergebnisse nach konservativer und operativer Therapie der distalen Radiusfraktur beim älteren Patienten

et al. 2016

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Fractures of the distal radius in elderly patients increasingly contribute to the workload in emergency departments worldwide. There is still no consensus about the best treatment option, e. g. closed reduction and cast stabilization, percutaneous pinning, external fixation or open reduction and internal fixation with volar locking plates (ORIF). In addition, the influence of pharmacological antiosteoporotic treatment (e. g. bisphosphonates) is unclear. In this overview five comparative studies were analyzed, which had been identified in a previous systematic review. The evaluation included 3 cohort studies and 2 randomized trials enrolling a total of 515 patients. A clinical or statistical advantage of ORIF over conservative treatment with respect to DASH scores 12 months after the index fracture event could not be demonstrated with a mean difference of 0.25 (95 % confidence interval CI -0.57-1.07). According to current best scientific evidence from preclinical and clinical investigations, antiosteoporotic medication does not have an unfavorable influence on fracture healing and should be continued due to its proven effectiveness in reducing subsequent osteoporotic fractures. Following distal radius fractures in elderly patients with clinical risk factors, an osteoporosis screening should be routine practice and a specific therapy should be initiated if the fracture risk is increased.

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Distale Radiusfrakturen

Rudolph

Gerhardt

Schmidt-Horlohé

et al. 2016

Trauma Berufskrankh

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Winkelstabile Plattenosteosynthese am distalen Radius

Abstract: The hypothesis that a reduced BMD is accompanied by a poorer function and a higher rate of complications was refuted. Analysis of complications showed a trend to more BMD-dependent complications in the osteoporosis group.

Cited by 5 publications

References 32 publications

Osteoporotische Frakturen des distalen Radius

Osteoporotische Frakturen des distalen Radius

Klinische Ergebnisse nach konservativer und operativer Therapie der distalen Radiusfraktur beim älteren Patienten

Distale Radiusfrakturen

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