• Chirurg · May 2012

    [Volar locking plating for distal radial fractures. Is osteoporosis associated with poorer functional results and higher complications rates?].

    • C Voigt, A Plesz, G Jensen, C Katthagen, and H Lill.
    • Klinik für Unfall- und Wiederherstellungschirurgie, Diakoniekrankenhaus Friederikenstift gGmbH Hannover, Humboldtstr. 5, 30169, Hannover, Deutschland. christine.voigt@ddh-gruppe.de
    • Chirurg. 2012 May 1; 83 (5): 463-71.

    BackgroundThe 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 MethodsA 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.ResultsExemplary 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.ConclusionThe 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.

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…