COMPLICATIONS FOLLOWING NONOPERATIVE TREATMENT OF DISTAL RADIUS FRACTURES IN ELDERLY PATIENTS
Eftal GÜDEMEZ1, Fatih EKŞİOĞLU1, Gürhan ÖZCAN2, Behçet SEPİCİ2
1Kırıkkale Üniversitesi Tıp Fakültesi Ortopedi ve Travmatoloji Anabilim Dalı
2Ankara Eğitim ve Araştırma Hastanesi 1. Ortopedi ve Travmatoloji Kliniği, Ankara
Keywords: Distal Radius Fractures, Elderly Patients, Complications.
Introduction: Because of the general optimistic outlook to the distal radius fractures, the management of these fractures is fraught with complications such as neuropathies, malunion, arthritis, stiffness of the digits, tendon rupture, reflex sympathetic dystrophy, and even Volkman’s contracture. The aim of this study was to evaluate the complications following non-surgically treated distal radius fractures in patients older than 60 years. Materials and
Methods: Fifty-five elderly patients with 56 fractures were included in this study. The patients ranged in age from 60 to 78 years (mean age, 67.8 years) at the time of injury. According to Fernandez classification system, the two most common patterns were complex and bending type fractures (33 and 20 patients, respectively). The treatment protocol consisted of closed reduction with manipulation and long arm cast application for 3 weeks followed by short-arm splint for additional 2 weeks. At the follow-up examinations, the patients were examined for malunions, acute or chronic neuropathies, stiffness of the digits, tendon rupture, and reflex sympathetic dystrophy. The average follow-up period was 16.6 months (range, 6-23 months).
Results: Malunion ratio was 14.2% (8 cases). Transient paresthesias occurred in the median nerve distribution areas of 3 patients (5.3%). Two patients (3.5%) had chronic neuropathies. In addition, the stiffness of the digits was detected in 3 patients (5.3%) and reflex sympathetic dystrophy in 9 patients (16.07%). There were no tendon ruptures and Volkman’s contractures. No arthritic changes of the radiocarpal and distal radioulnar joint could be detected.
Conclusion: The complications are more often than expected in elderly patients with distal radius fractures following conservative treatment methods. Because of that, these old patients with distal radius fractures must be carefully examined. The aim of the treatment must be getting favorable results both in radiological and clinical means.