Diepold Julian, Filipp Sebastian, Dussing Florian, Steiner Gernot, Deininger Christian, Gotterbarm Tobias, Wichlas Florian
Orthopaedics and Traumatology, Kepler Universitätsklinikum, Linz, Austria.
Johannes Kepler University of Linz, Linz, Austria.
Arch Orthop Trauma Surg. 2025 Sep 10;145(1):442. doi: 10.1007/s00402-025-06047-9.
The NOM (non-operative management) of distal radius fractures (DRF) is influenced by various factors. This study seeks to determine whether poor fracture alignment correlates with poor outcome.
Over a period of three years, a study was conducted on conservatively treated DRF involving 127 patients, 104 women (81.9%) and 23 men (18.1%). The average age was 70.6 years (SD ± 19.1; range 21 to 102 years). The patient population is categorized into two groups according to radiological healing outcomes: Group I and Group II. The classification threshold was established as (1) > 10° dorsal/volar tilt of the lateral articular surface angle. (2) Radial tilt of the anteroposterior joint surface angle exceeds 10 degrees. (3) The loss in radial height surpasses 4 mm. Patients were categorized into group II if they met two or more criteria for DRFs, while those with one or fewer criteria were placed in group I.
Group I exhibited superior mobility across all planes, except in radial abduction. There was also a significant improvement in the clinical scores (QuickDASH, PRWE). Patients over 70 years with anatomically healed distal radius fractures (Group I) had superior range of motion in all planes, with the exception of radial abduction. Group II exhibited significantly higher scores (QuickDASH, PRWE).
Thus, the ultimate goal-both in younger and older patients-should remain to achieve the best possible anatomical reduction. And especially in geriatric people, anatomical repositioning demonstrates enhanced ROM and significantly improvement in patient's satisfaction and daily functioning.
桡骨远端骨折（DRF）的非手术治疗（NOM）受多种因素影响。本研究旨在确定骨折对位不良是否与预后不良相关。
在三年时间里，对127例接受保守治疗的DRF患者进行了研究，其中女性104例（81.9%），男性23例（18.1%）。平均年龄为70.6岁（标准差±19.1；范围21至102岁）。根据放射学愈合结果将患者人群分为两组：第一组和第二组。分类阈值设定为：（1）外侧关节面角背侧/掌侧倾斜>10°。（2）前后关节面角的桡侧倾斜超过10度。（3）桡骨高度丢失超过4毫米。符合两项或更多DRF标准的患者被归入第二组，而符合一项或更少标准的患者被归入第一组。
除桡侧外展外，第一组在所有平面上均表现出更好的活动度。临床评分（QuickDASH、PRWE）也有显著改善。70岁以上解剖复位的桡骨远端骨折患者（第一组）在所有平面上均具有更好的活动度，但桡侧外展除外。第二组的评分（QuickDASH、PRWE）明显更高。
因此，无论年轻患者还是老年患者，最终目标都应是尽可能实现最佳的解剖复位。尤其是在老年患者中，解剖复位可提高关节活动度，并显著提高患者满意度和日常功能。
