Treatment of the Distal Radius Fractures in the Elderly Patients

Young Do Koh; Dong Joon Kim; Jae Kwang Kim

doi:10.12790/jkssh.2013.18.2.95

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Do Koh, Kim, and Kim: Treatment of the Distal Radius Fractures in the Elderly Patients

Reviw Article

J Korean Soc Surg Hand 2013;18(2):95-102.

Published online: 12 June 2013

DOI: https://doi.org/10.12790/jkssh.2013.18.2.95

Treatment of the Distal Radius Fractures in the Elderly Patients

Young Do Koh, Dong Joon Kim, Jae Kwang Kim

Department of Orthopedic Surgery, Ewha Womans University School of Medicine, Seoul, Korea

Correspondence to: Jae Kwang Kim Department of Orthopaedic Surgery, Ewha Womans University School of Medicine, 1071 Anyangchoen-ro, Yangcheon-gu, Seoul 158-710, Korea TEL: +82-2-2650-5143 FAX: +82-2-2642-0349 E-mail: kimjk@ewha.ac.kr

Received 4 June 20136 June 2013 Accepted 6 June 2013

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Distal radius fractures are one of the most common types of fractures in the elderly. It is well documented that increased risk of a distal radius fracture in older patients is associated with decreased bone mineral density. Also, low bone mineral density increased severity of fracture and instability of fracture after reduction. Fracture displacement in the elderly does not necessarily result in functional impairment. Therefore, conservative treatment has been a mainstay treatment even in unstable fracture in the elderly. However, there is an increasing trend toward operative treatment recently, because functional demand increased in the elderly due to active life style and volar locking plate fixation enables the elderly early return to daily activity even in osteoporotic distal radius fracture.

Keywords: The elderly, Distal radius fracture, Osteoporosis

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Fig. 1.

A 74-year-old female patient was conservatively treated for unstable distal radius fracture due to several comorbidities including angina and asthma. (A) The distal radius fracture is relatively well reduced after initial closed reduction. (B) The radiographs demonstrates severe radial shortening and dorsal angulation at the time of cast removal, however, she satisfied her final outcome.

Fig. 2.

A 76-year-old female patient was treated with percutaenous K-wire fixation using Kapandji technique for unstable distal radius fracture. (A) The distal radius fracture is relatively well reduced after initial fixation. (B) However, the radiographs at 6 months postoperatively shows about 4 mm radial shortening.

Fig. 3.

A 68-year-old female patient was treated with volar locking plate fixation technique for unstable distal radius fracture. (A) The fracture is unstable because several dorsal angulation and dorsal communition are notified in initial radiographs. (B) The reduction is maintained until fracture is consolidation through volar locking plate fixation.

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