Clinical and functional analysis of closed reduction-plastering and volar locking plate methods in distal radius fractures in patients over 60 years of age

Ceyhun Çağlar; Ali Said Nazlıgül; Batuhan Akbulut; Mustafa Akkaya

doi:10.19161/etd.1208986

EN TR

Clinical and functional analysis of closed reduction-plastering and volar locking plate methods in distal radius fractures in patients over 60 years of age

Abstract

Aim: Many different methods have been described in the treatment of distal radius fractures (DRF) in the elderly population, and which one is the better method is a matter of debate among orthopedic surgeons. The aim of this study was to compare the results of closed reduction and plastering (CRP) and volar locking plate (VLP), which are used in the treatment of DRF in the elderly population. Materials and Methods: Between January 2019 and December 2020, 36 patients with DRF aged > 60 years were evaluated retrospectively. There were 19 patients in the CRP group and 17 patients in the VLP group. Wrist flexion, extension, pronation, supination, ulnar deviation, and radial deviation degrees and grip strength were measured in the first year of their treatment. The patients were evaluated functionally by patient-rated wrist evaluation (PRWE), modified Green and O'Brien score (MGOS), and resting and stress visual analogue scale (VAS). Results: In both groups, similar ROM values were obtained and no significant difference was observed. While the PRWE score was 17.5 ± 5.5 in the CRP group and 12.5 ± 4.8 in the VLP group, the MGOS score was 83.0 ± 7.4 in the CRP group and 86.8 ± 12.6 in the VLP group, and the scores were not significantly different (p = 0.802, p = 0.315). While there was almost no pain in both groups at rest, more pain was felt in the VKP group under stress. While grip strength was 20.9 ± 6.4 kg in the CRP group, it was 22.2 ± 6.8 kg in the VLP group, and there was no significant difference compared to the contralateral wrist. Conclusion: There is no clinical and functional difference between CRP and VLP in the one-year period after DRF treatment in the patient population aged > 60 years. Treatment should be planned according to the functional capacity of the patient.

Keywords

60 yaş üstü hastalardaki distal radius kırıklarında kapalı redüksiyon-alçılama ile volar kilitli plak yöntemlerinin klinik ve fonksiyonel analizi

Öz

Amaç: Yaşlı popülasyonda meydana gelen distal radius kırıklarının (DRK) tedavisinde pek çok farklı yöntem tanımlanmış olup hangisinin daha iyi bir yöntem olduğu ortopedik cerrahlar arasında tartışma konusudur. Bu çalışmanın amacı yaşlı popülasyondaki DRK tedavisinde tercih edilen kapalı redüksiyon-alçılama (KRA) ve açık redüksiyon-internal fiksasyon ile volar kilitli plak (VKP) tedavilerinin sonuçlarını karşılaştırmaktır. Gereç ve Yöntem: Ocak 2019-Aralık 2020 tarihleri arasında > 60 yaş DRK bulunan 36 hasta retrospektif olarak değerlendirildi. KRA grubunda 19, VKP grubunda ise 17 hasta mevcuttu. Hastaların tedavilerinin birinci yılında el bileği eklem hareket açıklıkları ölçüldü. El dinamometresi yardımıyla el bileği kavrama gücüne bakıldı. Ayrıca hastalar patient-rated wrist evaluation (PRWE), modified Green ve O'brien score (MGOS), istirahat ve stres visual analogue scale (VAS) ile fonksiyonel olarak değerlendirildi. Bulgular: Her iki grupta da takiplerinin birinci yılında el bilekte benzer eklem hareket açıklığı değerleri elde edilmiş olup anlamlı bir fark görülmedi. PRWE skoru, KRA grubunda 17,5 ± 5,5, VKP grubunda 12,5 ± 4,8 iken MGOS skoru KRA grubunda 83,0 ± 7,4 VKP grubunda 86,8 ± 12,6 bulunmuş olup her iki skor arasındaki fark istatistiksel olarak anlamlı değildi (p=0,802, p=0,315). İstirahat anında her iki grupta da neredeyse hiç ağrı yok iken stres altında VKP grubunda daha çok ağrı hissedilmiştir. Kavrama gücü KRA grubunda 20,9 ± 6,4 kg iken VKP grubunda 22,2 ± 6,8 kg ölçülmüş olup sağlam el bileğine göre anlamlı fark bulunamadı. Sonuç: 60 yaş üstü hasta popülasyonundaki DRK tedavi sonrası bir yıllık süreçte KRA ve VKP yöntemleri arasında klinik ve fonksiyonel sonuçlar açısından fark bulunmamaktadır. Hastanın fonksiyonel kapasitesine göre tedavi planlaması düşünülmelidir.

Anahtar Kelimeler

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Details

Primary Language

English

Subjects

Health Care Administration

Journal Section

Research Article

Authors

Ceyhun Çağlar ^*
Türkiye

Ali Said Nazlıgül
Türkiye

Batuhan Akbulut
Türkiye

Mustafa Akkaya
Türkiye

Publication Date

December 12, 2022

Submission Date

April 11, 2022

Acceptance Date

June 28, 2022

Published in Issue

Year 1970 Volume: 61 Number: 4

DOI

https://doi.org/10.19161/etd.1208986

IZ

https://izlik.org/JA97ZJ52TK

Cite

RIS / Bibtex

Vancouver

1.Ceyhun Çağlar, Ali Said Nazlıgül, Batuhan Akbulut, Mustafa Akkaya. Clinical and functional analysis of closed reduction-plastering and volar locking plate methods in distal radius fractures in patients over 60 years of age. EJM. 2022 Dec. 1;61(4):666-73. doi:10.19161/etd.1208986