Treatment of comminuted distal radius fractures by resurfacing prosthesis in elderly patients

In elderly patients, distal radius fractures are often associated with osteoporotic bone. Under these conditions, anatomic resurfacing implants may provide satisfactory results in terms of range of motion, pain and function. Between July 2009 and January 2012, eight elderly patients were treated with the SOPHIA™ implant at our hand surgery department. Inclusion criteria were isolated comminuted distal radius AO type C2 fractures in patients greater than 70 years of age. All patients were reviewed in February 2013 by an independent surgeon. Clinical, functional and radiographic assessments were performed. Mean follow-up was 25 months (range 17-36 months). Mean ROM was 45° (range 40-50°) in flexion and 44° (range 40-50°) in extension. Mean pronation-supination range was 160°. Mean grip strength was 18 kgf. Mean Quick DASH was 18.2/100 (range 6.82-29.55) and mean pain on VAS was 2.33 (range 0-4). X-rays did not reveal any implant loosening or ulnar translation of the carpus. Use of a wrist resurfacing implant led to rapid recovery of autonomy in elderly patients with comminuted distal radius fractures. It parallels the use of shoulder or elbow prostheses for complex joint fractures in the elderly.