Surgical options for distal radius fractures of type C in elderly patients over 65 years old: a comparison of external fixation with Kirschner wires and volar locking plate
Abstract Background ue to the lack of consensus on the optimal surgical treatment for distal radius fractures (DRF) in elderly patients over 65 years old, the purpose of this study was to compare the efficacy of external fixation (EF) with Kirschner wires and volar locking plate (VLP) in the treatme...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-09-01
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| Series: | Journal of Orthopaedic Surgery and Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13018-023-04162-0 |
| _version_ | 1797557687964139520 |
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| author | He Zhang Man Liu Si-Yu Duan Hai-Rui Liang Rong-Da Xu Zhen-Cun Cai |
| author_facet | He Zhang Man Liu Si-Yu Duan Hai-Rui Liang Rong-Da Xu Zhen-Cun Cai |
| author_sort | He Zhang |
| collection | DOAJ |
| description | Abstract Background ue to the lack of consensus on the optimal surgical treatment for distal radius fractures (DRF) in elderly patients over 65 years old, the purpose of this study was to compare the efficacy of external fixation (EF) with Kirschner wires and volar locking plate (VLP) in the treatment of DRF through a retrospective cohort study. We hypothesized that there would be no significant difference in overall complications and functional recovery between the two methods. Methods We retrospectively analyzed 62 patients over 65 years old who underwent surgical treatment for C-type DRF between 2019 and 2022. Based on the different treatment methods, they were divided into the EF group and the VLP group. General data, inpatient data, and postoperative complications during follow-up were recorded. The X-ray images before surgery, after surgery, and at the last follow-up were analyzed, and the results of wrist motion range, Gartland–Werley wrist joint score, and DASH score were evaluated 6 months after surgery for both groups. Result Thirty patients underwent closed reduction and external fixation combined with Kirschner wire fixation, while 32 underwent open reduction and VLP fixation. The EF group had significantly shorter operation time, intraoperative blood loss, injury-to-surgery time, and hospital stay compared to the VLP group (all p < 0.001). At the last follow-up, the radiographic parameters (ulnar variance and radial inclination) and wrist joint function (wrist dorsiflexion and forearm supination) were better in the VLP group than in the EF group (p = 0.04, p = 0.01, p = 0.001, p = 0.02, respectively). However, there was no significant difference in overall Gartland-Werley wrist joint score, DASH score, and incidence of postoperative complications between the two groups (p = 0.31, p = 0.25, p = 0.47, respectively). Conclusion For patients aged 65 and above with distal radius fractures (DRF) of type C, VLP and external fixation with Kirschner wires yield comparable functional outcome and complications rate at the short term. However, VLP allowed restoration of better radiological parameters. |
| first_indexed | 2024-03-10T17:20:10Z |
| format | Article |
| id | doaj.art-4ca0ebd458b34cfb940c8c353dc43ea0 |
| institution | Directory Open Access Journal |
| issn | 1749-799X |
| language | English |
| last_indexed | 2024-03-10T17:20:10Z |
| publishDate | 2023-09-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Orthopaedic Surgery and Research |
| spelling | doaj.art-4ca0ebd458b34cfb940c8c353dc43ea02023-11-20T10:20:58ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2023-09-011811810.1186/s13018-023-04162-0Surgical options for distal radius fractures of type C in elderly patients over 65 years old: a comparison of external fixation with Kirschner wires and volar locking plateHe Zhang0Man Liu1Si-Yu Duan2Hai-Rui Liang3Rong-Da Xu4Zhen-Cun Cai5Department of Orthopedics Surgery, Central Hospital Affiliated to Shenyang Medical CollegeSchool of Basic Medical Sciences, Shenyang Medical CollegeDepartment of Orthopedics Surgery, Central Hospital Affiliated to Shenyang Medical CollegeDepartment of Orthopedics Surgery, Central Hospital Affiliated to Shenyang Medical CollegeDepartment of Orthopedics Surgery, Central Hospital Affiliated to Shenyang Medical CollegeDepartment of Orthopedics Surgery, Central Hospital Affiliated to Shenyang Medical CollegeAbstract Background ue to the lack of consensus on the optimal surgical treatment for distal radius fractures (DRF) in elderly patients over 65 years old, the purpose of this study was to compare the efficacy of external fixation (EF) with Kirschner wires and volar locking plate (VLP) in the treatment of DRF through a retrospective cohort study. We hypothesized that there would be no significant difference in overall complications and functional recovery between the two methods. Methods We retrospectively analyzed 62 patients over 65 years old who underwent surgical treatment for C-type DRF between 2019 and 2022. Based on the different treatment methods, they were divided into the EF group and the VLP group. General data, inpatient data, and postoperative complications during follow-up were recorded. The X-ray images before surgery, after surgery, and at the last follow-up were analyzed, and the results of wrist motion range, Gartland–Werley wrist joint score, and DASH score were evaluated 6 months after surgery for both groups. Result Thirty patients underwent closed reduction and external fixation combined with Kirschner wire fixation, while 32 underwent open reduction and VLP fixation. The EF group had significantly shorter operation time, intraoperative blood loss, injury-to-surgery time, and hospital stay compared to the VLP group (all p < 0.001). At the last follow-up, the radiographic parameters (ulnar variance and radial inclination) and wrist joint function (wrist dorsiflexion and forearm supination) were better in the VLP group than in the EF group (p = 0.04, p = 0.01, p = 0.001, p = 0.02, respectively). However, there was no significant difference in overall Gartland-Werley wrist joint score, DASH score, and incidence of postoperative complications between the two groups (p = 0.31, p = 0.25, p = 0.47, respectively). Conclusion For patients aged 65 and above with distal radius fractures (DRF) of type C, VLP and external fixation with Kirschner wires yield comparable functional outcome and complications rate at the short term. However, VLP allowed restoration of better radiological parameters.https://doi.org/10.1186/s13018-023-04162-0Distal radius fractureExternal fixationVolar locking plateSurgical outcome |
| spellingShingle | He Zhang Man Liu Si-Yu Duan Hai-Rui Liang Rong-Da Xu Zhen-Cun Cai Surgical options for distal radius fractures of type C in elderly patients over 65 years old: a comparison of external fixation with Kirschner wires and volar locking plate Journal of Orthopaedic Surgery and Research Distal radius fracture External fixation Volar locking plate Surgical outcome |
| title | Surgical options for distal radius fractures of type C in elderly patients over 65 years old: a comparison of external fixation with Kirschner wires and volar locking plate |
| title_full | Surgical options for distal radius fractures of type C in elderly patients over 65 years old: a comparison of external fixation with Kirschner wires and volar locking plate |
| title_fullStr | Surgical options for distal radius fractures of type C in elderly patients over 65 years old: a comparison of external fixation with Kirschner wires and volar locking plate |
| title_full_unstemmed | Surgical options for distal radius fractures of type C in elderly patients over 65 years old: a comparison of external fixation with Kirschner wires and volar locking plate |
| title_short | Surgical options for distal radius fractures of type C in elderly patients over 65 years old: a comparison of external fixation with Kirschner wires and volar locking plate |
| title_sort | surgical options for distal radius fractures of type c in elderly patients over 65 years old a comparison of external fixation with kirschner wires and volar locking plate |
| topic | Distal radius fracture External fixation Volar locking plate Surgical outcome |
| url | https://doi.org/10.1186/s13018-023-04162-0 |
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