Intra-articular distal radius fractures in elderly patients: a randomized prospective study of casting versus volar plating
- PMID: 28870129
- DOI: 10.1177/1753193417727139
Intra-articular distal radius fractures in elderly patients: a randomized prospective study of casting versus volar plating
Abstract
We compared outcomes in elderly patients with intra-articular distal radius fractures treated by closed reduction and plaster immobilization or open reduction and internal fixation with a volar plate. Ninety-seven patients older than 60 years were randomly allocated to conservative (47 patients) or surgical (50 patients) treatment. Over a 2-year period, we assessed patient-rated wrist evaluation score, DASH (disability arm, shoulder and hand) questionnaire, pain, wrist range of motion, grip strength, and radiological parameters. The functional outcomes and quality of life were significantly better after volar plating fixation compared with conservative treatment. We found that restoration of the articular surface, radial inclination, and ulnar variance affected the outcomes, but the articular step-off did not. Twenty-five per cent of the patients with conservative treatment had secondary loss of reduction. We conclude that surgical plating leads to better outcomes than conservative treatment for elderly patients with intra-articular distal radius fractures.
Level of evidence: I.
Keywords: Distal radius fracture; conservative treatment; elderly; intra-articular fracture; surgical treatment; volar plating.
Comment in
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Commentary on Martinez-Mendez D. et al. Intra-articular distal radius fractures in elderly patients: a randomized prospective study of casting versus volar plating.J Hand Surg Eur Vol. 2018 Feb;43(2):148-149. doi: 10.1177/1753193417748300. J Hand Surg Eur Vol. 2018. PMID: 29378488 No abstract available.
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Re: Martinez-Mendez D, Lizaur-Utrilla A, de-Juan-Herrero J. Intra-articular distal radius fractures in elderly patients: a randomized prospective study of casting versus volar plating. J Hand Surg Eur. 2018, 43: 142-7.J Hand Surg Eur Vol. 2019 May;44(4):434-435. doi: 10.1177/1753193419828923. J Hand Surg Eur Vol. 2019. PMID: 30950723 No abstract available.
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