Department of Orthopaedics, Regional Hospital Randers, Skovlyvej 15, 8930, Randers, Denmark.
Department of Clinical Medicine, HEALTH, Aarhus University, Palle Juul-Jensens Boulevard 82, 8200, Aarhus, Denmark.
Sci Rep. 2023 Nov 30;13(1):21102. doi: 10.1038/s41598-023-48630-3.
Recent studies have shown that distal radius fractures (DRFs) in elderly patients can be treated nonoperatively with good functional results after 1 year. However, scientific evidence regarding longer follow-up to assess posttraumatic arthritis (PA), complications, and functional outcomes is scarce. This prospective case series aimed to evaluate these outcomes in a cohort of patients ≥ 65-year-old with nonoperatively treated DRFs after a minimum of 3 years. The primary outcome was PA. Secondary outcomes were complications, Quick Disabilities of the Arm, Shoulder and Hand Outcome Measure (QuickDASH), Patient-Rated Wrist/Hand Evaluation (PRWHE), pain, range of motion and grip strength. The full data of 32 patients with a mean follow-up of 3.3 years were available: 10/32 patients had radiological signs of PA, but only 2 of these patients reported pain. A total of 11/32 fractures healed in malunion (> 10° dorsal angulation). There was no significant difference in QuickDASH or PRWHE from 1 year to the latest follow-up after more than 3 years. This study thus adds to the literature stating that radiological signs, including PA and malunion, do not necessarily result in symptoms. Moreover, it underpins that nonoperative treatment of these patients results in good functional outcomes after 1 and 3 years.
最近的研究表明，对于老年患者的桡骨远端骨折（DRF），1 年后非手术治疗可获得良好的功能结果。然而，关于更长时间随访以评估创伤后关节炎（PA）、并发症和功能结果的科学证据仍然缺乏。本前瞻性病例系列研究旨在评估≥65 岁的 DRF 患者在至少 3 年的非手术治疗后这些结局。主要结局是 PA。次要结局是并发症、上肢功能障碍评分（QuickDASH）、患者报告腕/手评估（PRWHE）、疼痛、活动度和握力。共有 32 例患者的完整数据可供分析，平均随访 3.3 年：10/32 例患者有 PA 的放射学征象，但只有 2 例患者有疼痛。11/32 例骨折愈合存在畸形愈合（>10°背侧成角）。3 年以上随访超过 1 年时，QuickDASH 或 PRWHE 无显著差异。因此，本研究补充了文献，表明放射学征象（包括 PA 和畸形愈合）不一定会导致症状。此外，它支持对这些患者进行非手术治疗可在 1 年和 3 年后获得良好的功能结果。
