Medical vs. Surgical management with volar plate in elderly patients with distal extra articular radius fracture

Abstract

Distal radius fractures are one of the most frequent injuries found it emergency service. Conservative treatment was very frequent until few years ago. However in past decades we have seen a progressive tendency to surgical treatment of this type of fractures, because of multiple complications that came with conservative management.

Objective: to compare the evolution of 50 years or older patients with distal extra articulate fractures of distal radius who were treated with conservative vs. volar plate, and attended in external consultation of orthopedics and trauma department in Hospital Escuela during the period between June 2009 and June 2010.

Methods: descriptive, longitudinal study, with a 27 patients sample with diagnosis of a distal extra articulate radius fracture who were treated with a conservative method because of evolution time, vs. patients treated with volar plate, both groups were evaluated in two and three month after the first treatment. We analyze radiological changes, function, pain and consequences related to both methods.

Results: The majority didn't present changes in angulations and radius height. In both treatments the most common consequence was the articular range motion. Patients treated with volar plate could do their daily activities with low grade difficulty, however patients treated with conservative management 12 weeks after the fracture, had moderate difficulty to do their activities

Conclusions: patients treated by surgery presented less alteration in radiological evaluation and have better function 8 weeks after surgery because of rigid stabilization and early movement

Key Words: Distal radius fracture; conservative management; surgical management; complications; function

DOI: http://dx.doi.org/10.5377/rmpm.v13i3.622

Revista de los Postgrados de Medicina UNAH Vol. 13 N° 3 Agosto-Octubre 2010