Ali Fazal Muhammad, Denis Mitchell Christopher, Ashwood Neil
Department of Trauma & Orthopaedics, Royal Free Hospitals London NHS Foundation Trust, The Ridgeway, Enfield, London, UK.
Consultant Orthopaedic Surgeon, Department of Trauma & Orthopaedics, Burton Hospital NHS Foundation Trust, Burton Upon Trent, UK.
J Clin Orthop Trauma. 2020 Jul-Aug;11(4):642-645. doi: 10.1016/j.jcot.2020.05.025. Epub 2020 May 28.
There is no unanimity for the treatment of distal radius fractures in older people. The purpose of our study is to assess the efficacy of volar locking plate for the treatment of unstable distal radius fractures in older independent individuals.
A retrospective comparative study of 105 patients. 58 patients were below the age of 55 years and 47 above the age of 55 years. Mean follow-up was 18.4 months in patients below the age of 55 years and 18.1 months above the age of 55 years. Wrist movements, complications, reoperations, grip strength, Visual Analogue Score (VAS) for pain, Quick Disabilities of the Arm, Shoulder and Hand (DASH) score, and Mayo wrist score were analysed.
There was no statistical difference in the wrist movements, grip strength, complications, reoperations, VAS, QuickDASH and Mayo scores. Mean grip strength under 55 was 84.1 and above 55 was 84.5 (p = 0.87). The complication rate was 19.1% above 55 years of age and 17.2% below the age of 55years (p = 0.79). The reoperation rate above 55 years was 8.5% and below 55 years was 8.6% (p = 0.50). Mean VAS under 55 years of age was 1.6 and above 55 years was 1.7 (p = 0.58). Mean Mayo score in under 55 was 80.7 and 80.1 in above 55 (p = 0.78). Mean Quick DASH score under 55 was 20.9 and above 55 was 21.0 (p = 0.97).
Our results indicate that outcomes in older independent patients are satisfactory with a comparable complication and reoperation rate with younger individuals. We conclude that a volar locking plate is a favourable modality for the treatment of unstable distal radius fractures in older patients.
老年人桡骨远端骨折的治疗方法尚无统一标准。本研究的目的是评估掌侧锁定钢板治疗老年独立个体不稳定桡骨远端骨折的疗效。
对105例患者进行回顾性对比研究。58例患者年龄在55岁以下，47例患者年龄在55岁以上。55岁以下患者的平均随访时间为18.4个月，55岁以上患者为18.1个月。分析了腕关节活动度、并发症、再次手术情况、握力、疼痛视觉模拟评分（VAS）、手臂、肩部和手部快速残疾评分（QuickDASH）以及梅奥腕关节评分。
腕关节活动度、握力、并发症、再次手术情况、VAS评分、QuickDASH评分和梅奥评分方面无统计学差异。55岁以下患者的平均握力为84.1，55岁以上患者为84.5（p = 0.87）。55岁以上患者的并发症发生率为19.1%，55岁以下患者为17.2%（p = 0.79）。55岁以上患者的再次手术率为8.5%，55岁以下患者为8.6%（p = 0.50）。55岁以下患者的平均VAS评分为1.6，55岁以上患者为1.7（p = 0.58）。55岁以下患者的平均梅奥评分为80.7，55岁以上患者为80.1（p = 0.78）。55岁以下患者的平均QuickDASH评分为20.9，55岁以上患者为21.0（p = 0.97）。
我们的结果表明，老年独立患者的治疗效果令人满意，并发症和再次手术率与年轻个体相当。我们得出结论，掌侧锁定钢板是治疗老年患者不稳定桡骨远端骨折的一种理想方式。
