Orthopedics Today Hawaii

Orthopedics Today Hawaii

Issue: February 2012
February 01, 2012
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Age cited as important variable in conservative treatment of distal radius fractures

Issue: February 2012
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Thomas F. Varecka, MD
Thomas F. Varecka

WAILEA, Hawaii – Age may be the most important variable in determining success of cast treatment for distal radius fractures, according to a presenter at Orthopedics Today Hawaii 2012.

“Distal radius fractures are a public health epidemic. Latest figures show that 450,000 to 500,000 distal radius fractures occur per year in the United States,” Thomas F. Varecka, MD, said here.

Distal radius fractures represent about 6% of all emergency department visits and about 20% of all musculoskeletal emergency department visits, he said. However, questions remained such as when to cast and what are the reasonable chances that fracture manipulation and reduction can be held with a cast. Varecka said there are now tools to predict which patients are at risk for loss of reduction/malunions.

“The paradox of age is that the younger patient is frequently perceived as being most benefitted by [open reduction and internal fixation] ORIF, yet, the younger patient is most likely to maintain acceptable reduction [with a cast]. The elderly patient is perceived as not benefitting from ORIF, but is less likely to maintain reduction [with a cast],” he said.

Hand and wrist stiffness, and decreased supination/pronation also continue to be major hurdles.

Reference:
  • Varecka TF. Distal radial fractures: The place for conservative treatment. Presented at Orthopedics Today Hawaii 2012, Jan. 15-18. Wailea, Hawaii.
  • Disclosure: Varecka has no relevant financial disclosures.

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