Skip to main content

Advertisement

Log in

Wrist hemiarthroplasty for irreparable DRF in the elderly

  • Original Article • WRIST - FRACTURES
  • Published:
European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Introduction

The authors update their results of wrist hemiarthroplasty for irreparable distal radius fracture in the elderly, at a minimum of 2-year follow-up.

Materials and methods

Between 2011 and 2018, 25 consecutive independent elderly patients (24 female, 27 wrists) were treated with wrist hemiarthroplasty for distal radius fracture at a single institution. The average age was 77 years (range 65–88). They all were independent at home. A total of 19 wrists were treated at the acute stage, and 8 secondary procedures. The average follow-up was 32 months (range 24–44).

Results

There was no dislocation, loosening, infection nor removal of the implants. We observed 3 CRPS. At final follow-up, the average VAS pain was 1/10, mean forearm pronation/supination arc was 150°, and mean active flexion–extension arc was 60°. Average wrist extension was 36°. Mean grip strength was 68% of contralateral side. Mean Lyon wrist score was 74%. Mean Quick DASH score was 26%, and mean PRWE score was 25%.

Discussion

Our data suggest that treatment of acute irreparable distal radius fracture in the independent elderly patient with a bone-preserving primary wrist hemiarthroplasty may be a viable option. Longer-term follow-up are needed to confirm these preliminary data.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Similar content being viewed by others

References

  1. Orbay JL, Fernandez DL (2004) Volar fixed-angle plate fixation for unstable distal radius fractures in the elderly patient. YJHSU 29:96–102

    Google Scholar 

  2. Day CS, Daly MC (2012) Management of geriatric distal radius fractures. J Hand Surg 37:2619–2622. https://doi.org/10.1016/j.jhsa.2012.07.038

    Article  Google Scholar 

  3. Brogan DM, Ruch DS (2015) Distal radius fractures in the elderly. J Hand Surg 40:1217–1219. https://doi.org/10.1016/j.jhsa.2015.01.001

    Article  Google Scholar 

  4. Arora R, Lutz M, Deml C et al (2011) A prospective randomized trial comparing nonoperative treatment with volar locking plate fixation for displaced and unstable distal radial fractures in patients sixty-five years of age and older. J Bone Joint Surg Am 93:2146–2153. https://doi.org/10.2106/JBJS.J.01597

    Article  PubMed  Google Scholar 

  5. Richard MJ, Katolik LI, Hanel DP et al (2012) Distraction plating for the treatment of highly comminuted distal radius fractures in elderly patients. J Hand Surg 37:948–956. https://doi.org/10.1016/j.jhsa.2012.02.034

    Article  Google Scholar 

  6. Herzberg G, Burnier M, Marc A, Izem Y (2015) Primary wrist hemiarthroplasty for irreparable distal radius fracture in the independent elderly. J Wrist Surg 04:156–163. https://doi.org/10.1055/s-0035-1558841

    Article  Google Scholar 

  7. Herzberg G, Burnier M (2016) What is the role of primary or secondary hemiarthroplasty for distal radius fractures in independent elderly patients? Hand Surg Rehabil 35S:S137–S140. https://doi.org/10.1016/j.hansur.2016.03.004

    Article  CAS  PubMed  Google Scholar 

  8. Vergnenègre G, Mabit C, Charissoux J-L et al (2014) Treatment of comminuted distal radius fractures by resurfacing prosthesis in elderly patients. Chir Main 33:112–117. https://doi.org/10.1016/j.main.2014.01.007

    Article  PubMed  Google Scholar 

  9. Roux J-L (2009) Replacement and resurfacing prosthesis of the distal radius: a new therapeutic concept. Chir Main 28:10–17. https://doi.org/10.1016/j.main.2008.11.009

    Article  PubMed  Google Scholar 

  10. Roux J-L (2011) Treatment of intra-articular fractures of the distal radius by wrist prosthesis. Orthop Traumatol Surg Res 97S:S46–S53

    Google Scholar 

  11. Ichihara S, Díaz JJH, Peterson B et al (2015) Distal radius isoelastic resurfacing prosthesis: a preliminary report. J Wrist Surg 4:150–155. https://doi.org/10.1055/s-0035-1556855

    Article  PubMed  PubMed Central  Google Scholar 

  12. Herzberg G, Burnier M, Nakamura T (2018) A new wrist clinical evaluation score. J Wrist Surg 07:109–114. https://doi.org/10.1055/s-0037-1607328

    Article  Google Scholar 

  13. Herzberg G, Merlini L, Burnier M (2017) Hemi-arthroplasty for distal radius fracture in the independent elderly. Orthop Traumatol Surg Res. https://doi.org/10.1016/j.otsr.2017.03.029

    Article  PubMed  Google Scholar 

  14. Brogan DM, Richard MJ, Ruch D, Kakar S (2015) Management of severely comminuted distal radius fractures. J Hand Surg 40:1905–1914. https://doi.org/10.1016/j.jhsa.2015.03.014

    Article  Google Scholar 

  15. Bartosh RA, Saldana MJ (1990) Intraarticular fractures of the distal radius: a cadaveric study to determine if ligamentotaxis restores radiopalmar tilt. YJHSU 15:18–21

    CAS  Google Scholar 

  16. Schultzel M, Scheidt K, Klein CC et al (2017) Hemiarthroplasty for the treatment of distal humeral fractures: midterm clinical results. J Shoulder Elbow Surg 26:389–393. https://doi.org/10.1016/j.jse.2016.09.057

    Article  PubMed  Google Scholar 

  17. Shukla DR, McAnany S, Kim J et al (2016) Hemiarthroplasty versus reverse shoulder arthroplasty for treatment of proximal humeral fractures: a meta-analysis. J Shoulder Elbow Surg 25:330–340. https://doi.org/10.1016/j.jse.2015.08.030

    Article  PubMed  Google Scholar 

  18. Desai SJ, Lalone E, Athwal GS et al (2016) Hemiarthroplasty of the elbow: the effect of implant size on joint congruency. J Shoulder Elbow Surg 25:297–303. https://doi.org/10.1016/j.jse.2015.09.022

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Guillaume Herzberg.

Ethics declarations

Conflict of interest

The senior author of this paper has a conflict of interests with this paper.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Herzberg, G., Walch, A. & Burnier, M. Wrist hemiarthroplasty for irreparable DRF in the elderly. Eur J Orthop Surg Traumatol 28, 1499–1503 (2018). https://doi.org/10.1007/s00590-018-2228-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00590-018-2228-5

Keywords

Navigation