Thorninger Rikke, Wæver Daniel, Pedersen Jonas, Tvedegaard-Christensen Jens, Tjørnild Michael, Lind Martin, Rölfing Jan Duedal
Department of Orthopaedics, Randers Regional Hospital, 8930 Randers, Denmark.
Department of Clinical Medicine, HEALTH, Aarhus University, 8000 Aarhus, Denmark.
J Clin Med. 2021 Apr 22;10(9):1831. doi: 10.3390/jcm10091831.
Distal radius fractures (DRF) in the elderly population above 65 years represent 18% of all fractures and are thereby the second most frequent fracture in the elderly. Fracture dislocation and comminution are often used to determine whether non-operative or operative treatment is indicated. The purpose of this prospective case series of minimally displaced DRF treated with a dorsal cast was to assess the complication rate and patient-reported outcome measures. This single-centre, single-blinded, prospective case series followed 50 conservatively treated DRF patients for one year. Primary outcomes were complications and Quick Disability of Arm Shoulder and Hand (qDASH) score. Secondary outcomes were range of motion (ROM), grip strength and pain, and Patient-Rated Wrist/Hand Evaluation (PRWHE). Results showed only minor complications with a return to prior ROM, qDASH, and pain after 12 months and improvement in outcomes after 6-12 months. In conclusion, the majority of DRF patients who were treated non-operatively with five-week dorsal casting recover fully after minimally displaced DRF. This standard approach is thus considered safe, and the present results provide a reference for other studies.
65岁以上老年人群的桡骨远端骨折（DRF）占所有骨折的18%，因此是老年人中第二常见的骨折。骨折脱位和粉碎程度常被用于确定是采取非手术治疗还是手术治疗。本前瞻性病例系列研究旨在评估采用背侧石膏治疗的轻度移位DRF的并发症发生率以及患者报告的结局指标。该单中心、单盲、前瞻性病例系列研究对50例接受保守治疗的DRF患者进行了为期一年的随访。主要结局指标为并发症和手臂、肩部和手部快速残疾（qDASH）评分。次要结局指标为活动范围（ROM）、握力和疼痛，以及患者自评腕/手评估（PRWHE）。结果显示仅出现轻微并发症，12个月后患者恢复到之前的ROM、qDASH评分及疼痛水平，6至12个月后结局有所改善。总之，大多数接受为期五周背侧石膏非手术治疗的DRF患者在轻度移位DRF后完全康复。因此，这种标准方法被认为是安全的，目前的结果为其他研究提供了参考。
