With the purpose of identifying the prevalence of distal radius fractures, their treatment, and comorbidities in patients seen at Clínica Medilaser in Tunja between 2019 and 2021. Methodology: We established a sample of 69 patients who arrived at emergency care services with a diagnosis of distal radius fracture. We conducted a characterization of the population, which we followed with a bivariate analysis of sociodemographic and clinical characteristics in relation to complications and clinical outcomes; for those with significant associations, a logistic regression was performed. Results: The prevalence of distal radius fractures in our emergency consulting population was 3.73%, while the prevalence of this fracture among all upper limb fractures was 36.64%. Surgical treatment was preferred in 73.9% of cases, with Kirschner wires being the more commonly used at 43.8%. Only 8.7% of patients required further surgery after an average of 50.5 days, 4.4% experienced infections at the surgical site within the first 30 days, and 14.3% showed strength deficit when compared to the opposite hand. A significant association was found between the need for reoperation and rural origin (p = 0.034) and the combined fixation of Kirschner wires with a palmar plate (p = 0.044). Conclusions: Distal radius fractures at our institution showed a high prevalence with a low complication rate. Furthermore, associations were found between the sociodemographic and clinical characteristics of the population and the presence of complications and unsatisfactory outcomes.
References
[1]
Chung, K.C. and Spilson, S.V. (2001) The Frequency and Epidemiology of Hand and Forearm Fractures in the United States. TheJournalofHandSurgery, 26, 908-915. https://doi.org/10.1053/jhsu.2001.26322
[2]
MacIntyre, N.J. and Dewan, N. (2016) Epidemiology of Distal Radius Fractures and Factors Predicting Risk and Prognosis. JournalofHandTherapy, 29, 136-145. https://doi.org/10.1016/j.jht.2016.03.003
[3]
Heng, B.Q.H., Kang, Y.C., Lim, J.X.Y. and Chee, K.G. (2020) Epidemiology of Distal Radius Fixations and Functional Outcomes in the Superelderly Population. TheJournalofHandSurgery (Asian-PacificVolume), 25, 26-31. https://doi.org/10.1142/s2424835520500034
[4]
Alencar Neto, J.B.d., Jales, C.d.S., Coelho, J.V.d.V., Souza, C.J.D.d. and Cavalcante, M.L.C. (2022) Epidemiology, Classification, and Treatment of Bilateral Fractures of the Distal Radius. ActaOrtopédicaBrasileira, 30, 4-7. https://doi.org/10.1590/1413-785220223003e245185
[5]
Xavier, C.R.M., Dal Molin, D.C., dos Santos, R.M.M., dos Santos, R.D.T. and Neto, J.C.F. (2011) Surgical Treatment of Distal Radius Fractures with a Volar Locked Plate: Correlation of Clinical and Radiographic Results. RevistaBrasileiradeOrtopedia (EnglishEdition), 46, 505-513. https://doi.org/10.1016/s2255-4971(15)30404-3
[6]
Mauck, B.M. and Swigler, C.W. (2018) Evidence-Based Review of Distal Radius Fractures. OrthopedicClinicsofNorthAmerica, 49, 211-222. https://doi.org/10.1016/j.ocl.2017.12.001
[7]
Serrano de la Cruz, M.J. (2008) Fracturas distales de radio. Clasificación. Tratamiento conservador. Revista Española de Cirugía Osteoarticular, 46, 140-154.
[8]
Ochen, Y., Peek, J., van der Velde, D., Beeres, F.J.P., van Heijl, M., Groenwold, R.H.H., et al. (2020) Operative vs Nonoperative Treatment of Distal Radius Fractures in Adults: A Systematic Review and Meta-Analysis. JAMANetworkOpen, 3, e203497. https://doi.org/10.1001/jamanetworkopen.2020.3497
[9]
Jiang, J.J., Phillips, C.S., Levitz, S.P. and Benson, L.S. (2014) Risk Factors for Complications Following Open Reduction Internal Fixation of Distal Radius Fractures. TheJournalofHandSurgery, 39, 2365-2372. https://doi.org/10.1016/j.jhsa.2014.09.016
[10]
Mishra, P., Iqbal, M. and Faraj, A. (2020) Functional Outcome of Distal Radial Fractures in Patients with a Mean Age of 75 Years at a Mean Follow-Up of 5.4 Years. Cureus, 12, 4-9. https://doi.org/10.7759/cureus.11959
[11]
Ludvigsen, T., Matre, K., Gudmundsdottir, R.S., Krukhaug, Y., Dybvik, E.H. and Fevang, J.M. (2020) Surgical Treatment of Distal Radial Fractures with External Fixation versus Volar Locking Plate. JournalofBoneandJointSurgery, 103, 405-414. https://doi.org/10.2106/jbjs.20.00275
[12]
Shapiro, L.M., Kamal, R.N., Kamal, R., Sox-Harris, A., Egol, K., Wolinsky, P., et al. (2021) Distal Radius Fracture Clinical Practice Guidelines—Updates and Clinical Implications. TheJournalofHandSurgery, 46, 807-811. https://doi.org/10.1016/j.jhsa.2021.07.014
[13]
Luokkala, T., Laitinen, M.K., Hevonkorpi, T.P., Raittio, L., Mattila, V.M. and Launonen, A.P. (2020) Distal Radius Fractures in the Elderly Population. EFORTOpenReviews, 5, 361-370. https://doi.org/10.1302/2058-5241.5.190060
[14]
Yoon, J.O., You, S.L. and Kim, J.K. (2016) Intra-Articular Comminution Worsens Outcomes of Distal Radial Fractures Treated by Open Reduction and Palmar Locking Plate Fixation. JournalofHandSurgery (EuropeanVolume), 42, 260-265. https://doi.org/10.1177/1753193416682943
[15]
Turner, R.G., Faber, K.J. and Athwal, G.S. (2007) Complications of Distal Radius Fractures. OrthopedicClinicsofNorthAmerica, 38, 217-228. https://doi.org/10.1016/j.ocl.2007.02.002
[16]
Yuan, Z.Z., Yang, Z., Liu, Q. and Liu, Y.M. (2018) Complications Following Open Reduction and Internal Fixation versus External Fixation in Treating Unstable Distal Radius Fractures: Grading the Evidence through a Meta-Analysis. Orthopaedics&Traumatology: Surgery&Research, 104, 95-103. https://doi.org/10.1016/j.otsr.2017.08.020
[17]
Ángel, L., Espinoza, M., Soto, I.B., Everardo, R., Cruz, F., Reyes, E., et al. (2019) Consideraciones en fracturas por fragilidad de radio distal en adultos mayores. Caso clínico y opinión de expertos. OrthotipsAMOT, 15, 112-120. https://www.medigraphic.com/pdfs/orthotips/ot-2019/ot192g.pdf
[18]
Hevonkorpi, T.P., Launonen, A.P., Raittio, L., Luokkala, T., Kukkonen, J., Reito, A., et al. (2018) Nordic Innovative Trial to Evaluate Osteoporotic Fractures (NITEP-Group): Non-Operative Treatment versus Surgery with Volar Locking Plate in the Treatment of Distal Radius Fracture in Patients Aged 65 and over—A Study Protocol for a Prospective, Randomized Controlled Trial. BMCMusculoskeletalDisorders, 19, Article No. 106. https://doi.org/10.1186/s12891-018-2019-5
[19]
Levin, L.S., Rozell, J.C. and Pulos, N. (2017) Distal Radius Fractures in the Elderly. JournaloftheAmericanAcademyofOrthopaedicSurgeons, 25, 179-187. https://doi.org/10.5435/jaaos-d-15-00676
[20]
Raudasoja, L., Aspinen, S., Vastamäki, H., Ryhänen, J. and Hulkkonen, S. (2022) Epidemiology and Treatment of Distal Radius Fractures in Finland—A Nationwide Register Study. JournalofClinicalMedicine, 11, Article No. 2851. https://doi.org/10.3390/jcm11102851
[21]
Salazar, J.M., Carvajal, L.L. and Lozano, S.M. (2015) Fractura de Radio Distal Como Predictor de Fractura de Cadera en Mayores de 65 Años de un Hospital Universitario de Alta Complejidad en Bogota. http://repository.urosario.edu.co/bitstream/handle/10336/11338/CarvajalMedinaSalazar14octubrecorregidopararepositoriopdf.pdf?sequence=1
[22]
González, C.A., Suarez, D.A., Vanegas, D., Restrepo, C. and Herrera, A.M. (2020) Fracturas inestables de radio distal intra y extraarticulares: Análisis comparativo de resultados a mediano plazo del tratamiento quirúrgico con placas volares. RevistaColombianadeOrtopediayTraumatología, 34, 45-52. https://doi.org/10.1016/j.rccot.2020.04.008
[23]
McFadyen, I., Field, J., McCann, P., Ward, J., Nicol, S. and Curwen, C. (2011) Should Unstable Extra-Articular Distal Radial Fractures Be Treated with Fixed-Angle Volar-Locked Plates or Percutaneous Kirschner Wires? A Prospective Randomised Controlled Trial. Injury, 42, 162-166. https://doi.org/10.1016/j.injury.2010.07.236
[24]
Serrano, M.J. (2008) Fracturas distales de radio Clasificación. Tratamiento conservador. RevistaEspañoladeCirugíaOsteoarticular, 46, 141-154.
[25]
Porrino, J.A., Maloney, E., Scherer, K., Mulcahy, H., Ha, A.S. and Allan, C. (2014) Fracture of the Distal Radius: Epidemiology and Premanagement Radiographic Characterization. AmericanJournalofRoentgenology, 203, 551-559. https://doi.org/10.2214/ajr.13.12140
[26]
Goehre, F., Otto, W., Schwan, S., Mendel, T., Vergroesen, P.P. and Lindemann-Sperfeld, L. (2013) Comparison of Palmar Fixed-Angle Plate Fixation with K-Wire Fixation of Distal Radius Fractures (AO A2, A3, C1) in Elderly Patients. JournalofHandSurgery (EuropeanVolume), 39, 249-257. https://doi.org/10.1177/1753193413489057
[27]
Rozental, T.D., Blazar, P.E., Franko, O.I., Chacko, A.T., Earp, B.E. and Day, C.S. (2009) Functional Outcomes for Unstable Distal Radial Fractures Treated with Open Reduction and Internal Fixation or Closed Reduction and Percutaneous Fixation: A Prospective Randomized Trial. TheJournalofBoneandJointSurgery-AmericanVolume, 91, 1837-1846. https://doi.org/10.2106/jbjs.h.01478
[28]
Koo, K.O.T., Tan, D.M.K. and Chong, A.K.S. (2013) Distal Radius Fractures: An Epidemiological Review. OrthopaedicSurgery, 5, 209-213. https://doi.org/10.1111/os.12045
[29]
Rotella, J.M., Rotella, P.S., Martinez Martinez, F. and Moreno Fernandez, J.M. (2016) Fracturas del extremo distal del radio: Resultados funcionales y radiográficos de 2 técnicas diferentes. RevistaLatinoamericanadeCirugíaOrtopédica, 1, 143-150. https://doi.org/10.1016/j.rslaot.2017.02.008
[30]
Costa, M.L., Achten, J., Rangan, A., Lamb, S.E. and Parsons, N.R. (2019) Percutaneous Fixation with Kirschner Wires versus Volar Locking-Plate Fixation in Adults with Dorsally Displaced Fracture of Distal Radius: Five-Year Follow-Up of a Randomized Controlled Trial. TheBone&JointJournal, 101, 978-983. https://doi.org/10.1302/0301-620x.101b8.bjj-2018-1285.r1
[31]
Nellans, K.W., Kowalski, E. and Chung, K.C. (2012) The Epidemiology of Distal Radius Fractures. HandClinics, 28, 113-125. https://doi.org/10.1016/j.hcl.2012.02.001
[32]
Marcheix, P., Dotzis, A., Benkö, P., Siegler, J., Arnaud, J. and Charissoux, J. (2010) Extension Fractures of the Distal Radius in Patients Older than 50: A Prospective Randomized Study Comparing Fixation Using Mixed Pins or a Palmar Fixed-Angle Plate. JournalofHandSurgery (EuropeanVolume), 35, 646-651. https://doi.org/10.1177/1753193410364179
[33]
Costa, M.L., Achten, J., Parsons, N.R., Rangan, A., Griffin, D., Tubeuf, S., et al. (2014) Percutaneous Fixation with Kirschner Wires versus Volar Locking Plate Fixation in Adults with Dorsally Displaced Fracture of Distal Radius: Randomised Controlled Trial. BMJ, 349, g4807. https://doi.org/10.1136/bmj.g4807
[34]
Karantana, A., Downing, N.D., Forward, D.P., Hatton, M., Taylor, A.M., Scammell, B.E., et al. (2013) Surgical Treatment of Distal Radial Fractures with a Volar Locking Plate versus Conventional Percutaneous Methods. JournalofBoneandJointSurgery, 95, 1737-1744. https://doi.org/10.2106/jbjs.l.00232
[35]
Youlden, D.J., Sundaraj, K. and Smithers, C. (2018) Volar Locking Plating versus Percutaneous Kirschner Wires for Distal Radius Fractures in an Adult Population: A Meta‐Analysis. ANZJournalofSurgery, 89, 821-826. https://doi.org/10.1111/ans.14903
[36]
Chaudhry, H., Kleinlugtenbelt, Y.V., Mundi, R., Ristevski, B., Goslings, J.C. and Bhandari, M. (2015) Are Volar Locking Plates Superior to Percutaneous K-Wires for Distal Radius Fractures? A Meta-Analysis. ClinicalOrthopaedics&RelatedResearch, 473, 3017-3027. https://doi.org/10.1007/s11999-015-4347-1
[37]
Chung, S.R. and Chung, K.C. (2023) Recognizing and Treating Unique Distal Radius Fracture Patterns That Are Prone to Displacement. HandClinics, 39, 279-293. https://doi.org/10.1016/j.hcl.2023.02.004
[38]
Mallon, Z.O. and Schlauch, A.M. (2023) A Novel Surgical Technique for Distal Radius Fractures Using the “Mini Distractor”. TraumaCaseReports, 47, Article ID: 100926. https://doi.org/10.1016/j.tcr.2023.100926
[39]
Rundgren, J., Enocson, A., Järnbert-Pettersson, H. and Mellstrand Navarro, C. (2020) Surgical Site Infections after Distal Radius Fracture Surgery: A Nation-Wide Cohort Study of 31,807 Adult Patients. BMCMusculoskeletalDisorders, 21, Article No. 845. https://doi.org/10.1186/s12891-020-03822-0
[40]
Perregaard, S., Jørgensen, R.W. and Landgren, M. (2024) Complications after Volar Locking Plate Fixation of Distal Radius Fractures: A Retrospective Study of 822 Patients. TheJournalofHandSurgery, 49, 745-750. https://doi.org/10.1016/j.jhsa.2022.11.012
[41]
Sharma, H., Khare, G.N., Singh, S., Ramaswamy, A.G., Kumaraswamy, V. and Singh, A.K. (2014) Outcomes and Complications of Fractures of Distal Radius (AO Type B and C): Volar Plating versus Nonoperative Treatment. JournalofOrthopaedicScience, 19, 537-544. https://doi.org/10.1007/s00776-014-0560-0
[42]
Mathews, A.L. and Chung, K.C. (2015) Management of Complications of Distal Radius Fractures. HandClinics, 31, 205-215. https://doi.org/10.1016/j.hcl.2014.12.002
