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Arch Hand Microsurg > Volume 20(2); 2015 > Article
Original Article
Journal of the Korean Society for Surgery of the Hand 2015;20(2):43-50.
Published online June 30, 2015.
DOI: https://doi.org/10.12790/jkssh.2015.20.2.43   
Comparative Study of Outcomes between Operative and Non-Operative Treatment of Unstable Distal Radius Fracture in the Elderly Patients
Jong Min Kim, Hyun Je Seo, Young Dae Jeon, Hyung Min Lee, Jung Hwan Son
Department of Orthopedic Surgery, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan, Korea. junghson@dreamwiz.com
Received: 19 March 2015   • Revised: 17 June 2015   • Accepted: 20 June 2015
Abstract
Purpose
The goal of this retrospective study is to compare radiologic outcome and clinical outcome between operative and non-operative treatment of unstable distal radius fracture in patients over 65-year-old.

Methods
From December 2006 to December 2011, 114 patients over 65-year-old were enrolled in the present study. 45 patients underwent non-operative treatment, and 69 patients underwent operative treatment. We retrospectively reviewed radiologic results and clinical results and then compared the two groups. Radiologic results include radial inclination (RI), volar tilt angle (VT) and radial shortening (RS) shown on the last radiograph and clinical results including disabilities of the arm, shoulder and hand (DASH) scores, modified Mayo wrist score (MMWS), and range of motion (ROM) of wrist.

Results
All cases presented bone-union. Among the patients who received non-operative treatments, average RI of 15.5degrees, average VT of 14.1degrees, average RS of 5.3 mm, The patients who received operative treatments showed average volar tilt of 3.9degrees, average VT of 18.2degrees, and average RS of 1.1 mm. RS showed a significant difference (p<0.05). At Clinical evaluation, DASH score, MMWS score, the ROM of wrist joint did not show significant difference (p>0.05).

Conclusion
Our results suggest that non-operative treatment is initially recommended in patients over 65 years who have an unstable distal radius fracture in terms of functional results.
 
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