S3043 DISTAL RADIUS FRACTURE

Abstract

Radius fracture is the earliest and one of the most common symptoms of osteoporosisò1/6 of fractures seen in the emergency roomòand many patients with distal radius fractures would benefit from osteoporosis treatment to prevent future fractures. Nearly 80% are women, most frequent between 60–70 years of age; men have a more flattened incidence curve.

As to classification, distal radius fractures span a wide spectrum, but the sheer bulk of them calls for a simple and robust classification with a low interobserver error. Older’s classification gives an indication of the risk for redislocation, and perhaps the presence/localisation of comminution in the distal/metaphyseal areas are more prognostic than the dislocation per se in unstable fractures.

Despite improved surgical treatment, most series still report dissatisfaction rates around 20% with significant complications. One reason is that the population of patients with fragility fractures is so heterogeneous in terms of autonomy, cognitive function, and functional demands. Although anatomy does correlate with function, a stratification in background factors seems to be reasonable. The chronological age of the patient and the radiological classification grade of the fracture are often not the most important factors in terms of functional outcome, health-related quality of life and patient satisfaction in the long run.

The indications for reduction and external/internal fixations are still unclear, but there has been clear trend towards a more active approach, and a combination of different surgical techniques. But since it is still unclear whether surgical intervention of most fracture types will produce consistently better long-term outcomes, there is a need for evidence for the management of these fractures in terms of efficacy (clinical trials) and effectiveness (general practice).