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Conservative treatment of distal fractures after the age of 65: a review of literature

  • Original Article • WRIST - FRACTURES
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Abstract

The goal of this study was to evaluate the role of conservative treatment of distal radius fractures in the elderly since 2000. Our series included 22 articles, of which 3 reviews, 2 meta-analyses, 6 descriptive series of conservative treatment, 10 series comparing surgical and conservative treatments and 1 series comparing different types of conservative treatments. The reduction was performed by closed reduction in 7 cases and by traction in 3 cases. A short-arm cast was used in 8 cases and a long-arm cast in 4 cases for an average length of 6 weeks. The indications of conservative treatment were varied: AO type A fractures in 2 cases, type C fractures in 1 case, types A and C in 8 cases and types A, B and C in 3 cases. No article reported any significant difference between surgical and conservative treatments in terms of DASH or PRWE, whereas strength was sometimes improved when surgical treatment was used. Radiological results were always better after surgical treatment. The rate of complications varied greatly, greater, equally or lower compared to conservative treatment depending on the series. All in all, there is no consensus to assert that a conservative treatment is more justified than a surgical treatment to treat distal radius fractures after the age of 65. Most authors consider that the long-term clinical outcome is identical and that the radiological result is better after surgical treatment. The fact that the fixation of a distal radius fracture by a volar locking plate after 65 years speeds up the recovery remains to be proven.

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Authors and Affiliations

  1. Department of Hand Surgery, SOS Main, CCOM, University Hospital of Strasbourg, FMTS, University of Strasbourg, Icube CNRS 7357, 10 Avenue Baumann, 67400, Illkirch, France

    Alexandra Bruyere, Paul Vernet, Santiago Salazar Botero, Yuka Igeta, Juan José Hidalgo Diaz & Philippe Liverneaux

  2. Department of Orthopedic Surgery, Juntendo University, Tokyo, Japan

    Yuka Igeta

Authors
  1. Alexandra Bruyere
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  2. Paul Vernet
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  3. Santiago Salazar Botero
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  4. Yuka Igeta
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  5. Juan José Hidalgo Diaz
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  6. Philippe Liverneaux
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Correspondence to Philippe Liverneaux.

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Conflicts of interest

Philippe Liverneaux has conflicts of interest with Newclip Technics, Argomedical, Zimmer Biomet, Biomodex. None of the other authors have conflicts of interest.

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Bruyere, A., Vernet, P., Botero, S.S. et al. Conservative treatment of distal fractures after the age of 65: a review of literature. Eur J Orthop Surg Traumatol 28, 1469–1475 (2018). https://doi.org/10.1007/s00590-018-2150-x

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  • DOI: https://doi.org/10.1007/s00590-018-2150-x

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