Department of Orthopaedic Surgery, JPS Health Network, Fort Worth, TX, USA.
University of North Texas Health Science Center, Fort Worth, TX, USA.
J Hand Surg Asian Pac Vol. 2024 Apr;29(2):125-133. doi: 10.1142/S2424835524500140. Epub 2024 Mar 15.
We aim to evaluate the impact of advanced age and sex on postoperative complications and radiographic outcomes after open reduction with internal fixation of distal radius fractures (DRF). We conducted a retrospective chart review, including all patients who underwent open reduction with internal fixation of a DRF between 2012 and 2018 at a single level 1 trauma centre. We recorded patient age, sex, fracture classification (Arbeitsgemeinschaft für Osteosynthesefragen/Orthopaedic Trauma Association [AO/OTA]), time from injury to surgical date, surgical duration, diabetes status, tobacco use, illicit drug use, history of osteoporosis, use of adjuvants, fixation type, postoperative radiographic restoration of normal parameters and early complications including loss of reduction within 30 days postoperatively. Advanced age was defined as age greater than 60 years. A total of 521 patients underwent operative treatment - 264 males and 257 females. Males were twice as likely (23.5% vs. 10.1%; < 0.0001) to sustain a type C3 fracture and be treated with a wrist spanning plate (5.3% vs. 0; < 0.0001). A larger percentage of elderly patients undergoing operative treatment of DRF were female (20.2% vs. 5.7%; < 0.0001) and females were more likely to carry a pre-injury diagnosis of osteoporosis (9.3% vs. 0%; < 0.0001). And 100% of the elderly patients received were treated with a volar plate. The overall early loss of reduction was 7.5%. The overall complication rate was 8.2%. No differences in early postoperative complications were identified between sexes or age groups. Neither female sex nor advanced age was found to have increased risk of postoperative complications or early loss of reduction. Similar postoperative radiographic parameter measurements were obtained across groups as well. Our results support the idea that operative treatment of unstable DRF in elderly patients and women is a reasonable treatment option without significant increases in early postoperative complications. Level III (Therapeutic III).
我们旨在评估年龄增长和性别对桡骨远端骨折（DRF）切开复位内固定术后并发症和影像学结果的影响。我们进行了一项回顾性图表审查，纳入了 2012 年至 2018 年期间在一家一级创伤中心接受 DRF 切开复位内固定术的所有患者。我们记录了患者年龄、性别、骨折分类（AO/OTA）、从受伤到手术的时间、手术时间、糖尿病状态、吸烟史、药物滥用史、骨质疏松症病史、辅助药物使用、固定类型、术后影像学恢复正常参数以及早期并发症，包括术后 30 天内复位丢失。年龄较大定义为年龄大于 60 岁。共有 521 例患者接受了手术治疗，其中男性 264 例，女性 257 例。男性更有可能（23.5% vs. 10.1%；<0.0001）发生 C3 型骨折，并接受腕关节板固定（5.3% vs. 0；<0.0001）。接受 DRF 手术治疗的老年患者中，女性比例更高（20.2% vs. 5.7%；<0.0001），且女性更有可能在受伤前被诊断为骨质疏松症（9.3% vs. 0%；<0.0001）。100%的老年患者接受了掌侧钢板固定。总的早期复位丢失率为 7.5%。总的并发症发生率为 8.2%。男女之间或年龄组之间没有发现早期术后并发症存在差异。女性性别或年龄增长均未增加术后并发症或早期复位丢失的风险。各组术后影像学参数测量结果也相似。我们的研究结果支持这样的观点，即对老年患者和女性不稳定 DRF 进行手术治疗是一种合理的治疗选择，不会显著增加术后早期并发症。III 级（治疗性 III 级）。
