Treatment of fractures of the distal end of the radius in elderly: ORIF with a fixed-angle plate versus external fixation

摘要

The fractures of distal radius are the most common fractures of the upper extremity. These fractures are experienced by all ages and demonstrate a bimodal distribution, with peak ages of 6 to 10 and 60 to 69 years. The authors analyze results of treatment of unstable distal radius fractures in elderly. 83 wrists in 82 patients older than 60 years were treated in operating room with ORIF with a fixed-angle plates in 42 cases (group I), external fixation in 41 cases (group II).Mean follow-up was 12 months. Results were evaluated according to a scheme which analyzed pain, mobility, strength, radiographic measurements, return to occupation and homework (D.A.S.H. score). In group I, results were deemed optimal in 24 patients(64,9%),in group II in 22 patients(56,4%). With a progressively older yet healthy population, more and more frequently patients remain physically active and engaging in sports. External fixation continues to have a role in the management of distal radius fractures. In the other hand, ORIF with a fixed angle plate facilitate accurate reduction and earlier implementation of activity.