Go Back   Rearm Yourself Community Forum > Main Category > Main Forum

Thread Tools Display Modes
Old 03-10-2012, 04:21 PM
mtomaino's Avatar
mtomaino mtomaino is offline
Super Moderator
Join Date: Mar 2010
Posts: 144
Default Distal Radius Fracture Treatment Update: If you are 65 years and older, is surgery or

In the December 2011 issue of the Journal of Bone and Joint Surgery, the question of whether surgery or a cast alone is better was addressed in a report entitled “A Prospective Randomized Trial Comparing Nonoperative Treatment with Volar Locking Plate Fixation for Displaced and Unstable Distal Radius Fractures in Patients Sixty-five Years of Age and Older.” This study design provided the highest level of evidence, and showed, at 12 months, that pain level, range of motion and global satisfaction scores were NOT different between the operative and nonoperative groups. However, patients in the operative group had better grip strength through the entire time period. Obtaining a “proper looking x-ray” did not result in better range of motion or improved ability to perform daily living activities. Early on in the follow-up period, patients in the operative group had better wrist extension.
So what does this mean? Well---firstly, it appears that the case FOR surgery is not necessarily made based on the “evidence”, although better extension early on, and better grip strength at 1 year did “favor” operative treatment. Another advantage of operative treatment is the opportunity to come out of a cast earlier---at 7-10 days as opposed to 5-6 weeks.
The take home message is that a recommendation for or against surgery may involve more than simply “outcome considerations.” So it’s important that you have a good understanding of why one or the other option is being advised in your case.
Reply With Quote

Thread Tools
Display Modes

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off

Forum Jump

All times are GMT -4. The time now is 08:03 PM.

Powered by vBulletin® Version 3.8.4
Copyright ©2000 - 2021, Jelsoft Enterprises Ltd.