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FRACTURES OF THE DISTAL END OF RADIUS IN ELDERLY PATIENTS – A COMPARATIVE STUDY OF ANATOMICAL AND FUNCTIONAL RESULTS-



Abstract

Objective: To compare the functional results with the anatomical results of treatment for fractures of the distal end of radius in patients aged over 60 years.

Methods: The results of treatment for fractures of the distal end of radius in 25 elderly patients were evaluated retrospectively. The average age of the patients was 70 years and the average follow-up period was 24 months. Twenty-one fractures were treated by percutaneous pinning, two were treated with plates, and two were treated conservatively. All patients were right-handed. The functional results were evaluated according to the sum of demerit points (Saito, 1983), and the following three parameters were used for evaluation of anatomical results: radial tilt, ulnar variance, and palmar tilt.

Results: The latest follow-up functional end results were excellent in 52 % of the fractures and good in 48%. In the final radiographs, the average radial tilt was 20.5 degrees, ulnar variance was 3.7 mm, and palmar tilt was 2.5 degrees. The values of ulnar variance and palmar tilt were often found to be out of the normal range. Most of the patients had a satisfactory outcome, and the functional results were not correlated with the magnitude of residual deformities. Grip power was the most significant factor related to subjective evaluation. Grip power recovered 75.2 % of uninjured side grip power in patients fractured left hands and 103.4 per cent in patients fractured right hands. This difference was significant (p< 0.05).

Conclusions: A good functional outcome of treatment for fractures of the distal end of radius in elderly patients can be expected irrespective of radiographic evidence of minor deformities.

The abstracts were prepared by Professor Jegan Krishnan. Correspondence should be addressed to him at the Flinders Medical Centre, Bedford Park 5047, Australia.