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Volar plate for intra-articular distal radius fracture. A prospective comparative study between elderly and young
Alejandro Lizaur-Utrilla1, Daniel Martinez-Mendez1, Maria F Vizcaya-Moreno2
1Servicio de cirugía ortopédica, hospital universitario de Elda, Ctra Elda-Sax s/n, 03600 Elda, Alicante, España.
Introduction:
Treatment of the distal radius fracture in elderly remains controversial. The objective was to assess the outcomes of volar locking plate for displaced complete intra-articular distal radius fractures in elderly as compared to younger patients.
Hypothesis:
The outcomes in elderly patients would be comparable with those in younger patients with a low rate of complications.
Material And Methods:
Non-randomised prospective comparative study between 70 patients older than 65 years and 46 younger patients with AO type-C fractures. The main outcome was Disabilities Arm, Shoulder and Hand (DASH) score. Secondary variables were Patient-Rated Wrist Evaluation (PRWE) score, range of motion, Visual Analogue Scale (VAS) for pain, and grip strength. Radiological measurements were also performed.
Results:
The mean follow-up was 30.9 (range, 24-53) months. There were no significant differences in mean DASH, PRWE, VAS-pain, wrist motion or radiological parameters at final follow-up. Multivariate analysis showed that the functional outcomes were significantly influenced by baseline ulnar positivity greater than 3mm at baseline but not by age.
Discussion:
The study hypothesis was confirmed. Surgical treatment with volar locking plate for displaced complete intra-articular fractures of the distal radius in elderly patients represents a safe and effective treatment alternative with similar early complication rate than in younger.
Level Of Evidence:
III, cohort study.
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