A simple method for choosing treatment of distal radius fractures.

PURPOSE: To design an easy-to-use guide for decision making in distal radius fractures in patients older than 50 years and to retrospectively analyze its ability to predict treatment in 164 patients.
METHODS: The present study consisted of 4 parts. The first part was a review of the literature to identify possible important factors that predict treatment outcome of distal radius fractures in patients 50 years old and older. The second part identified which of these first-tier factors that orthopedic surgeons consider to be important by a questionnaire that was sent to 83 orthopedic surgeons qualified by the Japanese Orthopedic Association with response rate of 61%. The third part further identified which of the subsets of factors best predict outcome in a retrospective study of 41 patients 50 years old or older, yielding a final subset of factors to create a scoring system. The fourth part of the study then evaluated the ability of this scoring system to predict the outcome as evaluated by the modified Mayo wrist score and the Disabilities of the Arm, Shoulder and Hand score in a retrospective study of 164 distal radius fractures in patients 50 years old or older.
RESULTS: The 164 patients were divided into 4 groups by the present scoring system: conservative group, relative conservative group, relative surgical group, and surgical group according to the recommended therapeutic modalities. Clinical outcomes of those that followed the recommendation of the present scoring system resulted in favorable consequences. In contrast, the outcomes of those not following the recommendation were inferior.
CONCLUSIONS: The present scoring system may be used as an easy-to-use decision-making tool when choosing conservative or surgical treatment for distal radius fractures.