Levin L Scott, Rozell Joshua C, Pulos Nicholas
From the Department of Orthopaedic Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA.
J Am Acad Orthop Surg. 2017 Mar;25(3):179-187. doi: 10.5435/JAAOS-D-15-00676.
Distal radius fractures are common in elderly patients, and the incidence continues to increase as the population ages. The goal of treatment is to provide a painless extremity with good function. In surgical decision making, special attention should be given to the patient's bone quality and functional activity level. Most of these fractures can be treated nonsurgically, and careful closed reduction should aim for maintenance of anatomic alignment with a focus on protecting fragile soft tissues. Locked plating is typically used for fracture management when surgical fixation is appropriate. Surgical treatment improves alignment, but improvement in radiographic parameters may not lead to better clinical outcomes. Treatment principles, strategies, and clinical outcomes vary for these injuries, with elderly patients warranting special consideration.
桡骨远端骨折在老年患者中很常见,并且随着人口老龄化,其发病率持续上升。治疗的目标是提供一个功能良好且无痛的肢体。在手术决策过程中,应特别关注患者的骨质和功能活动水平。这些骨折大多可以通过非手术治疗,仔细的闭合复位应旨在维持解剖学对线,重点是保护脆弱的软组织。当适合进行手术固定时,锁定钢板通常用于骨折治疗。手术治疗可改善对线,但影像学参数的改善可能不会带来更好的临床结果。这些损伤的治疗原则、策略和临床结果各不相同,老年患者需要特别考虑。