Intra-articular distal radius fractures in elderly patients: a randomized prospective study of casting versus volar plating.
J Hand Surg Eur Vol
; 43(2): 142-147, 2018 Feb.
Article
em En
| MEDLINE
| ID: mdl-28870129
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.
Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Fraturas do Rádio
/
Placas Ósseas
/
Moldes Cirúrgicos
/
Fraturas Intra-Articulares
/
Redução Fechada
/
Fixação Interna de Fraturas
Tipo de estudo:
Clinical_trials
/
Observational_studies
Aspecto:
Patient_preference
Limite:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
J Hand Surg Eur Vol
Ano de publicação:
2018
Tipo de documento:
Article
País de afiliação:
Espanha