The following is a summary of “Posttraumatic arthritis and functional outcomes of nonoperatively treated distal radius fractures after three years,” published in the November 2023 issue of Rheumatology by Thorninger et al.
Recent research has indicated the potential for nonoperative treatment of distal radius fractures (DRFs) in elderly patients, showing promising functional outcomes after one year. However, there remains a dearth of scientific evidence regarding longer-term assessments focusing on posttraumatic arthritis (PA), complications, and functional recovery. This prospective case series aimed to address this gap by evaluating these outcomes among a cohort of patients aged 65 years or older who received nonoperative treatment for DRFs, with a minimum follow-up duration of three years.
The primary objective of this study was to investigate the incidence of PA, while secondary outcomes encompassed complications, Quick Disabilities of the Arm, Shoulder, and Hand Outcome Measure (QuickDASH), Patient-Rated Wrist/Hand Evaluation (PRWHE), pain levels, range of motion, and grip strength. Comprehensive data from 32 patients, with an average follow-up duration of 3.3 years, were available for analysis. Among these patients, radiological signs of PA were observed in 10 individuals; notably, only 2 reported experiencing pain. Furthermore, 11 patients displayed fractures healed in malunion, exceeding a dorsal angulation of more than 10 degrees.
The findings revealed no significant disparity in QuickDASH or PRWHE scores between the one-year mark and the latest follow-up exceeding three years. This study contributes substantively to the existing body of literature by highlighting that radiological indicators, such as PA and malunion, do not invariably lead to symptomatic manifestations. Additionally, it reinforces the notion that nonoperative interventions for these patients yield favorable functional outcomes both after one and three years.
This investigation emphasizes the potential for nonoperative management in elderly patients with DRFs by shedding light on the longer-term outcomes beyond the initial one-year mark. The study underscores the importance of considering functional results and symptomatology in assessing treatment efficacy, suggesting that nonoperative approaches can deliver enduring positive functional outcomes despite radiological signs or malunion.
Source: nature.com/articles/s41598-023-48630-3
