Travmatologiâ i Ortopediâ Rossii (Mar 2024)
Treatment of Distal Radius Fractures in Elderly Patients: A Review
Abstract
Background. Distal radius fractures (DRF) are one of the most common injuries in the elderly population. Their incidence increases steadily, with epidemiologists predicting further growth. Despite its growing prevalence, the efficacy of surgical treatment for this pathology in elderly patients remains debatable. Aim — to determine the optimal method for treating distal radius fractures in the elderly population basing on a comparative analysis of the literature data on various treatment methods, including conservative and surgical ones. Methods. A search was performed in PubMed/MEDLINE, Scopus, Google Scholar, and eLIBRARY databases according to the following keywords, their derivatives and combinations in the titles and abstracts: treatment, distal radius fracture, elderly. Initial analysis for meeting the inclusion criteria was performed on the article titles and abstracts, followed by analysis of the full-text articles. The sources with unavailable full-text versions were excluded from the analysis. Results. Current epidemiological data were studied, specific aspects of physical examination of elderly patients with distal radius fractures were described, the main treatment methods were determined. The main treatment method remains the conservative one: closed reduction and immobilisation. Open reduction and internal fixation with a volar locking plate has become the leading surgical treatment method in recent decades, replacing such methods as closed reduction and fixation with wires or external fixation. At early follow-up, elderly patients operated on with volar locking plate show better functional results than those who received conservative treatment. However, at long-term follow-up, most studies show no significant differences in functional outcomes after surgical and conservative treatment, despite the differences in radiological data in favour of surgical treatment. Conclusion. For the majority of elderly patients, conservative treatment may be the optimal treatment option. Surgical intervention using a volar locking plate may be justified for certain groups of elderly patients, as this method may accelerate rehabilitation after injury.
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