Purpose
Previous studies have suggested little association between radiographic malalignment
and long-term functional outcomes of nonsurgical treatment of distal radius fractures
in geriatric patients. However, no report has stratified the elderly by age and focused
on short-term outcomes. The purpose of this study was to determine how the relationship
between malunion and patient outcomes differs between early- and late-geriatric patients
in the short and long terms after injury, thereby informing explanations and decision-making
on treatment options for geriatric patients with distal radius fractures.
Methods
One hundred patients treated nonsurgically for distal radius fractures were evaluated
retrospectively; 52 were defined as early-geriatric patients (aged 60–72 years) and
48 as late-geriatric (aged >77 years). Malunion (dorsal tilt > 10°, ulnar variance
> 3 mm, or intra-articular displacement or step-off > 2 mm), range of motion, and
grip strength were investigated at 3 months. Multiple regression analysis was performed
for each age group using Quick-Disabilities of the Arm, Shoulder, and Hand (QuickDASH)
scores at 3 months as the dependent variable. QuickDASH scores over 1 year after injury
were analyzed in the same way.
Results
The early-geriatric patients included 33 acceptable unions and 19 malunions. The late-geriatric
patients included 12 acceptable unions and 26 malunions. The significant predictors
of QuickDASH scores at 3 months were malunion for the early-geriatric group and grip
strength for the late-geriatric group (standardized coefficient β, 0.31 and −0.49,
respectively). No factor significantly predicted the QuickDASH scores after at least
1 year in either group.
Conclusions
Malunion was associated with worse QuickDASH scores at 3 months after injury in the
early-geriatric patients but not in the late-geriatric patients and did not predict
the QuickDASH scores at 1 year after injury in either age group.
Type of study/level of evidence
Prognostic IV.
Key words
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Article info
Publication history
Published online: February 08, 2023
Accepted:
December 23,
2022
Received:
August 23,
2022
Publication stage
In Press Corrected ProofFootnotes
No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.
Identification
Copyright
© 2023 by the American Society for Surgery of the Hand. All rights reserved.
