[Distal radius fractures. 2.4 mm locking compression plates. Are they worth the effort?]

Area of Science:

• Orthopedic Surgery
• Geriatric Medicine
• Biomaterials Science

Background:

• Distal radius fractures have a second incidence peak in older adults, often presenting as complex injuries requiring tailored treatment.
• Osteoporosis significantly increases fracture risk and complicates healing in the elderly population.
• Effective management strategies are crucial for restoring function and quality of life in geriatric patients with distal radius fractures.

Purpose of the Study:

• To evaluate the efficacy and complications of 2.4-mm locking compression (LC) plates for treating distal radius fractures in patients over 65 with osteoporosis.
• To compare the costs of LC plate treatment with alternative interventions for these fractures.
• To assess functional and radiological outcomes using the Lidström score.

Main Methods:

• A prospective study involving 37 patients (mean age 76 years) with distal radius fractures and osteoporosis.
• Fracture classification according to the AO system (9 Type A, 1 Type B, 27 Type C).
• Surgical intervention using 2.4-mm LC plates (26 volar, 7 dorsal, 4 "sandwich" procedures), with a mean follow-up of 11.1 months for 33 patients.

Main Results:

• Over 80% of patients achieved good or very good functional and radiological outcomes with 2.4-mm LC plates.
• Functional Lidström scores: 13 very good, 15 good, 4 fair, 1 poor.
• Radiological Lidström scores: 15 very good, 13 good, 4 fair, 1 poor.

Conclusions:

• 2.4-mm LC plates provide effective treatment for complex, osteoporotic distal radius fractures in patients over 65.
• While achieving high success rates, the intervention costs associated with LC plates are significantly higher compared to other treatment modalities.
• Further cost-benefit analyses are warranted to optimize treatment strategies for this patient demographic.