%0 Journal Article
%T Distal Radial Fractures in the Superelderly: Does Malunion Affect Functional Outcome?
%A N. D. Clement
%A A. D. Duckworth
%A C. M. Court-Brown
%A M. M. McQueen
%J ISRN Orthopedics
%D 2014
%R 10.1155/2014/189803
%X Purpose. The management of unstable distal radial fractures in the superelderly (¡Ý80 years old) remains controversial. The aim of this study was to compare the functional outcome of super-elderly patients with and without malunion after a distal radial fracture. Methods. We identified 51 superelderly patients living independently with displaced fractures from a prospective database of 4024 patients with distal radial fractures. Activities of daily living, presence of wrist pain, whether the wrist had returned to its normal level function, grip strength and ROM were recorded. The dorsal angulation was measured radiographically. Results. There were 17 (33.3%) patients defined to have a malunion. The outcomes of the independent patients with and without malunion were compared at a mean follow-up of 15 months. No difference was observed in activities of daily living , wrist pain , whether the wrist had returned to its normal level function , grip strength , or ROM . An increasing degree of dorsal angulation correlated with diminished ROM ( ), but did not correlate with activities of daily living ( ). Conclusions. Malunion of the distal radius does not influence the functional outcome of independent superelderly patients. 1. Introduction The most prevalent fracture that trauma surgeons manage are those involving the distal radius [1], accounting for 16% of all fractures [2]. Nonoperative management is generally employed for stable nondisplaced fractures of the distal radius with the expectation of a good functional outcome [3¨C5]. In contrast, the management of displaced fractures of the distal radius remains controversial. Although some authors suggest that functional outcome correlates with the anatomical reduction of the fracture [4, 6¨C8] others suggest that this may not be the case [9¨C11]. This disparity may be due to the heterogeneity of the reported cohorts, which vary in size, have a lack of standardised reporting, and often combine both intra- and extra-articular fractures within the reported series [12]. In addition, multiple studies have reported cohorts with a wide age range; in one series, the age difference between the youngest and oldest patients was 80 years [3, 13¨C15]. However, age has been demonstrated to influence outcome [12] and therefore may have skewed the results of these studies. It is predicted that there will be an increase in the elderly population over the next decade which is due to the 1950¡¯s Baby Boomers, and currently the fastest growing age group in the Western World is the ¡°oldest old¡± ( 85 years) [16]. It is anticipated that
%U http://www.hindawi.com/journals/isrn.orthopedics/2014/189803/