03 September 2019 : Clinical Research
The Necessity of Restoration of Radiologic Parameters by Closed Reduction in Elderly Patients with Distal Radius FracturesLingde Kong1ABDEF, Ningzhao Kou2BCDE, Yanxue Wang3BCDE, Jian Lu1BCD, Dehu Tian1EF, Bing Zhang1ADEF*
Med Sci Monit 2019; 25:6598-6604
BACKGROUND: The aim of this study was to evaluate the influence of distal radius fractures (DRFs) malalignment on the treatment outcomes in patients over age 65 years.
MATERIAL AND METHODS: We retrospectively reviewed the records on fresh DRFs treated with closed reduction from December 2014 to January 2018. After treatment, patients were evaluated for the determination of grip strength, the Visual Analog Scale (VAS) during wrist movement, the Patient-Rated Wrist Evaluation (PRWE), the Disabilities of the Arm, Shoulder and Hand (DASH) score, the appearance satisfaction, and active wrist range of motion (ROM).
RESULTS: A total of 96 patients with complete data were included in our study. During follow-up, there were 75 patients (78.1%) with acceptable reduction and 21 patients (21.9%) with unacceptable reduction. Compared with those having acceptable alignment in the distal radius, patients with unacceptable alignment had weak grip strength, were unsatisfied appearance, and had severe flexion as well as ulnar deviation limitation at 6-month follow-up. A significant correlation was found between ulnar positive variance and grip strength (r=–0.35, P=0.03), as well as dorsal angulation and flexion movement (r=–0.31, P=0.02).
CONCLUSIONS: Conservative treatment should be used differently, even in elderly patients. For low-demand patients, it is not necessary to restore all anatomic radiographic parameters, as malalignment does not increase disability or pain score. However, for patients who are still healthy and active, satisfactory reduction is the first choice, as malalignment can lead to decreased grip strength, dissatisfaction with appearance, and certain wrist limitations.
Keywords: Bone Malalignment, Manipulation, Orthopedic, Radius Fractures, Aged, Disability Evaluation, Follow-Up Studies, Hand Strength, Pain, Range of Motion, Articular
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