Frykman Type 7-8 Distal Radius Fractures in Elderly Patients: Conservative Treatment vs Volar Plating

TL;DR

This study compares plaster casting and surgery for wrist fractures in elderly patients and finds both methods yield similar outcomes.

Contribution

The study provides evidence that conservative treatment is as effective as surgery for certain wrist fractures in elderly patients.

Findings

Casting and volar plating showed similar functional and radiological outcomes in elderly patients.

Surgical treatment resulted in significantly greater volar tilt compared to casting.

Patients with radiological parameters within acceptable limits had better functional scores.

Abstract

Introduction: The aim of this study was to determine the clinical outcomes of conservative and surgical treatments in elderly patients with displaced Frykman type 7-8 distal radius fractures.

Methods: The clinical outcomes of 50 patients aged 60 and older with displaced Frykman type 7-8 fractures who underwent surgical and conservative treatments between January 2019 and January 2022 were determined. The joint range of motion, pain scores, functional scores, radiological parameters, and any complications that occurred posttreatment were evaluated for each patient who underwent both treatments.

Results: Descriptive characteristics, excluding sex, were evaluated in 18 patients treated with casting and 32 patients treated with volar plating, and no statistically significant differences were detected between the groups. The functional and radiological assessments of the groups showed no significant differences (p>0.05). The volar tilt of patients who underwent surgical treatment was significantly greater than that of patients who were treated with a cast (p=0.02). The Mayo wrist scores of patients with step-offs greater than 2 mm were significantly lower (p=0.007; p<0.01). The visual analog scale (VAS) scores of patients who met the step-off criterion were significantly greater (p=0.025; p<0.05). The Mayo wrist scores of patients whose radiological parameters were within acceptable limits were significantly greater (p=0.007; p<0.01). The Quick-Quick Disabilities of the Arm, Shoulder, and Hand (DASH) scores of patients whose radiological parameters were within acceptable limits were significantly lower (p=0.007; p<0.01).

Conclusion: In elderly patients with identified Frykman type 7-8 fractures, casting and volar plating treatments produced similar results. Especially in patients with low expectations and multiple comorbidities, satisfactory results can be achieved with plaster treatment.