ArticleJournal of orthopaedic surgery and research2023
Closed reduction of dorsally displaced distal radius fractures in the elderly provided improved final radiographic results.
Article in Journal of orthopaedic surgery and research, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed, 3 citations in OpenAlex.
- Article
- Comparative Discriminative Performance of Cast, Gap, and Three-Point Indices in Predicting Malunion in Elderly Patients with Conservatively Treated Distal Radius Fractures.Medicina (Kaunas, Lithuania) · 2026Article
- Management of undisplaced or minimally displaced distal radius fractures in adults: immobilization with circumferential casting versus plaster splinting.Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES · 2026Article
- Minimally Invasive Treatment of Die-Punch Fractures and Related X-Ray Parameters.Geriatric orthopaedic surgery & rehabilitation · 2026Article
- Article
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Authors and funding
6 authors at 3 institutions in 1 country.
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Abstract
backgroundRecent guidelines recommend non-operative treatment as primary treatment in elderly patients with displaced distal radius fractures. Most of these fractures are closely reduced. We aimed to evaluate the radiological results of closed reduction and casting of dorsally displaced distal radius fractures in patients 65 years or older.
methodsA total of 290 patients treated during the years 2015, 2018 and 2019 in an urban outpatient fracture clinic with complete follow-up at least 5 weeks post-reduction were available for analysis. Closed fracture reduction was performed by manual traction under hematoma block. A circular plaster of Paris cast was used. Radiographs pre- and post-reduction and at final follow-up were analyzed.
resultsMean age was 77 years (SD 8) and 258 (89%) were women. Dorsal tilt improved from mean 111° (range 83-139) to 89° (71-116) post-reduction and fell back to mean 98° (range 64-131) at final follow-up. Ulnar variance was 2 mm ((-1)-12) pre-reduction, 0 mm ((-3)-5) post-reduction and ended at mean 2 mm (0-8). Radial inclination went from 17° ((-6)-30) to 23° (SD 7-33), and then back to 18° (0-32) at final follow-up. 41 (14%) patients had worse alignment at final follow-up compared to pre-reduction. 48 (17%) obtained a position similar to the starting point, while 201 (69%) improved. Fractures with the volar cortex aligned after reduction retained 0.4 mm (95% Confidence Interval (CI) 0.1 to 0.7; p = 0,022) more radius length during immobilization. In a regression analysis, less ulnar variance in initial radiographs (OR 1.8 (95% CI 1.4 to 2.3) per mm, p < 0.001) and lower age (OR 1.06 (95% CI 1.02 to 1.09) per year, p < 0.003) protected against loss of reduction.
conclusionSubsequent loss of reduction after initial closed reduction was seen in most distal radius fractures. Reduction improved overall alignment in 2/3 of the patients at final follow-up. An aligned volar cortex seemed to protect partially against loss of radial length.
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