Functional outcomes after open reduction and internal fixation for treatment of displaced distal radius fractures in patients over 60 years of age

Abstract

Objective: To evaluate the clinical, radiographic, and functional outcomes of patients aged 60 and older treated with open reduction and internal fixation using plates and screws for displaced and comminuted fractures of the distal radius.

Design: Retrospective, clinical research.

Setting: Tertiary care center (Level 1 trauma center) located in a large urban area.

Patients: Eighteen patients with an average age of 71 years (range 60-86) form the basis of this study. Patients were obtained from a surgical database of 2 hand surgeons in a tertiary care center.

Intervention: Open reduction and internal fixation of fractures of the distal radius using metal plates and screws designed for treatment of these injuries.

Main outcome measurements: Clinical (history and physical examination), plain radiographic, and functional assessments were performed at an average follow-up of 26 months (range 12-40 months). Functional outcomes were assessed using the Gartland and Werley and Disabilities of the Arm, Shoulder, and Hand scoring systems.

Results: Satisfactory reduction was achieved in all 18 fractures at the time of operative fixation with no instances of loss of fracture reduction during the study period. There were no cases of malunion, nonunion, or instances of device failure. We identified 4 minor complications. No patients required reoperation. Fifteen patients had an excellent (83%) and 3 had a good (17%) result according to the Gartland and Werley scoring system. The mean Disabilities of the Arm, Shoulder, and Hand score was 4.4 (range 0-14) out of a maximum 100.

Conclusion: Our findings suggest that open reduction and internal fixation with plates and screws in patients 60 years and older with displaced and comminuted fractures of the distal radius represents a safe and effective treatment alternative.