C Voigt1, A Plesz, G Jensen, C Katthagen, H Lill. 1. Klinik für Unfall- und Wiederherstellungschirurgie, Diakoniekrankenhaus Friederikenstift gGmbH Hannover, Humboldtstr. 5, 30169, Hannover, Deutschland. christine.voigt@ddh-gruppe.de
Abstract
BACKGROUND: The purpose of this prospective study was to compare the functional and radiological results and complication rates after locking plate osteosynthesis of unstable distal radial fractures in elderly patients as a function of the bone mineral density (BMD). The hypothesis that reduced BMD is accompanied by poorer function and a higher rate of complications was investigated. PATIENTS AND METHODS: A total of 65 consecutive patients with unstable distal radial fractures, AO 23-A2 (n=1), -A3 (n=29), -C1 (n=2), -C2 (n=28) and -C3 (n=5) were included with a mean age of 69 years (range, 52-86 years). Standardized clinical and radiological follow-up was performed 6 weeks, 3 and 12 months postoperatively. All patients underwent dual x-ray absorptiometry of the contralateral distal radius within 6 weeks postoperatively and 3 groups could be differentiated: group I (n=27) osteoporosis, group II (n=27) osteopenia and group III (n=11) normal BMD. Data on the DASH and QAL scores as well as the range of motion, grip strength and radiological parameters were collected. According to the BMD a detailed analysis of complications was performed. RESULTS: Exemplary the 12 months results of DASH and the range of motion are shown here: the DASH 12 months postoperatively was DASH(total)=6 (0-64) P, DASH(group I)=7 (0-32.5) P, DASH(group II)=11 (1-63) P, DASH(group III)=2 (0-23) P, no significance. The range of motion increased significantly in all 3 groups (except pronation in groups I and III) from 6 weeks to 3 and 12 months postoperatively and 12 months postoperatively showed means for dorsal extension 55° (25-75), palmar flexion 55° (35-75), ulnar abduction 35° (20-45), radial abduction 20° (5-40), supination 90° (60-90) and pronation 85° (65-90) in the total sample. The comparison of DASH and range of motion was not significantly different at each time of follow-up between all 3 groups. A group-specific analysis of implant and BMD dependent complications showed 2/27 (7%) secondary intra-articular screw perforations in group I, 1/27 (4%) in group II and 0/11 in group III. CONCLUSION: The hypothesis that a reduced BMD is accompanied by a poorer function and a higher rate of complications was refuted. Analysis of complications showed a trend to more BMD-dependent complications in the osteoporosis group.
BACKGROUND: The purpose of this prospective study was to compare the functional and radiological results and complication rates after locking plate osteosynthesis of unstable distal radial fractures in elderly patients as a function of the bone mineral density (BMD). The hypothesis that reduced BMD is accompanied by poorer function and a higher rate of complications was investigated. PATIENTS AND METHODS: A total of 65 consecutive patients with unstable distal radial fractures, AO 23-A2 (n=1), -A3 (n=29), -C1 (n=2), -C2 (n=28) and -C3 (n=5) were included with a mean age of 69 years (range, 52-86 years). Standardized clinical and radiological follow-up was performed 6 weeks, 3 and 12 months postoperatively. All patients underwent dual x-ray absorptiometry of the contralateral distal radius within 6 weeks postoperatively and 3 groups could be differentiated: group I (n=27) osteoporosis, group II (n=27) osteopenia and group III (n=11) normal BMD. Data on the DASH and QAL scores as well as the range of motion, grip strength and radiological parameters were collected. According to the BMD a detailed analysis of complications was performed. RESULTS: Exemplary the 12 months results of DASH and the range of motion are shown here: the DASH 12 months postoperatively was DASH(total)=6 (0-64) P, DASH(group I)=7 (0-32.5) P, DASH(group II)=11 (1-63) P, DASH(group III)=2 (0-23) P, no significance. The range of motion increased significantly in all 3 groups (except pronation in groups I and III) from 6 weeks to 3 and 12 months postoperatively and 12 months postoperatively showed means for dorsal extension 55° (25-75), palmar flexion 55° (35-75), ulnar abduction 35° (20-45), radial abduction 20° (5-40), supination 90° (60-90) and pronation 85° (65-90) in the total sample. The comparison of DASH and range of motion was not significantly different at each time of follow-up between all 3 groups. A group-specific analysis of implant and BMD dependent complications showed 2/27 (7%) secondary intra-articular screw perforations in group I, 1/27 (4%) in group II and 0/11 in group III. CONCLUSION: The hypothesis that a reduced BMD is accompanied by a poorer function and a higher rate of complications was refuted. Analysis of complications showed a trend to more BMD-dependent complications in the osteoporosis group.
Authors: Lukas Konstantinidis; Peter Helwig; Peter C Strohm; Anja Hirschmüller; Philipp Kron; Norbert Paul Südkamp Journal: Arch Orthop Trauma Surg Date: 2009-11-06 Impact factor: 3.067
Authors: James Leone; Mohit Bhandari; Anthony Adili; Scott McKenzie; Jaydeep K Moro; R Brett Dunlop Journal: Arch Orthop Trauma Surg Date: 2003-11-08 Impact factor: 3.067