Lizaur-Utrilla Alejandro, Martinez-Mendez Daniel, Vizcaya-Moreno Maria F, Lopez-Prats Fernando A
Servicio de cirugía ortopédica, hospital universitario de Elda, Ctra Elda-Sax s/n, 03600 Elda, Alicante, España.
Servicio de cirugía ortopédica, hospital universitario de Elda, Ctra Elda-Sax s/n, 03600 Elda, Alicante, España.
Orthop Traumatol Surg Res. 2020 Apr;106(2):319-323. doi: 10.1016/j.otsr.2019.12.008. Epub 2020 Feb 7.
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.
The outcomes in elderly patients would be comparable with those in younger patients with a low rate of complications.
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.
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.
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.
III, cohort study.
老年桡骨远端骨折的治疗仍存在争议。目的是评估与年轻患者相比，掌侧锁定钢板治疗老年移位性完全关节内桡骨远端骨折的疗效。
老年患者的疗效与年轻患者相当，并发症发生率低。
对70例65岁以上患者和46例年轻的AO C型骨折患者进行非随机前瞻性对照研究。主要观察指标为上肢、肩部和手部功能障碍（DASH）评分。次要变量包括患者自评腕关节评估（PRWE）评分、活动范围、视觉模拟疼痛评分（VAS）和握力。同时进行影像学测量。
平均随访30.9（24 - 53）个月。末次随访时，平均DASH、PRWE、VAS疼痛评分、腕关节活动度或影像学参数均无显著差异。多因素分析显示，功能结局受基线尺骨正向变异大于3mm的显著影响，但不受年龄影响。
研究假设得到证实。掌侧锁定钢板手术治疗老年移位性完全关节内桡骨远端骨折是一种安全有效的治疗选择，早期并发症发生率与年轻患者相似。
III级，队列研究。
