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Journal of the Korean Society for Surgery of the Hand 2003;8(4):143-147.
Published online December 1, 2003.
Prognostic Factors Affected to Distal Radius Fracture in Elderly Patients
Kwang Suk Lee, Jong Ryoon Baek, Sang Bum Kim
노인에서 발생한 요골 원위부 골절에 관여한 예후 인자
이광석, 백종륜, 김상범
Abstract
Introduction: Many different kinds of treatment have been applied for fractures of the distal end of the radius and it has been reported that great functional results can be achieved through anatomical reduction. However, it raises a controversy that its effectiveness of applying surgical methods to less active elderly patients, to achieve an accurate anatomical reduction with chances of causing complications. In this paper, we analyse relationship between anatomical and functional results after operations in patients over 60 years old who were diagnosed as fractures of the distal end of the radius. Materials and methods: Thirty three cases of closed reduction and percutaneous pinning have been analysed for relationship between functional and anatomical results among 48 patients (50 cases), who were diagnosed fractures of the distal end of the radius and could be followed up for at least 6 months, from January 1997 to December 2002. In addition, many different factors are studied which provide the significant effects on prognosis. The functional results have been classified to subjective and objective evaluations, and the anatomical results have been categorised to radial inclination, radial length, volar tilt and ulnar variance for effective analysis. Results: There have been two cases in excellent, eighteen good, twelve fair and one poor in subjective evaluation, meanwhile, the four cases in excellent, eighteen good, nine fair and two poor cases have been reported in objective evaluation. Ulnar variance is considered to be the most influential factor according to relationship between anatomical and subjective including objective evaluations, and it has significant results statistically. Conclusion: It is difficult for elderly patients to overcome unstable fractures of the distal end of the radius only using plaster fixation and surgical operation is considered. However functional and anatomical results do not coincide for socially and physically less active elderly patients. In results, ulnar variance is to be considered the key factor affecting functional results.
 


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