| Abstract / Summary | Distal radius fractures (DRF) account for 18% of all fractures in the elderly ≥65 years of age. The
incidence rate of DRF is around 200-280 per 100,000 person-years. With rising age of the general
population, it is expected that DRF in the elderly will assume growing importance in the healthcare
system. The primary aim of this thesis was to prospectively investigate the complication rate and
functional outcome of displaced DRF after non-operative treatment vs. operative treatment with
volar plating in patients 65 years of age or older. The secondary aim of this thesis was to report the
complications, functional outcome and radiological evaluation of minimally or non-displaced DRF
in the same age group. The tertiary aim was to evaluate the complications and functional outcome
between non-operative treatment of minimally/non-displaced vs. displaced DRF.
This thesis is based on four papers including a randomised controlled trial and three prospective
observational studies.
Paper I is the published study protocol of the randomised controlled trial.
Paper II evaluated the clinical outcome of minimally or non-displaced DRF in patients treated nonoperatively
according to the national clinical guidelines (NCG). The main purpose of this study was
to provide reliable and up-to-date information about Danish patients with DRF before fracture and
at 5 weeks, 6 months, and 12 months. The outcomes measured were complications and functional
outcome. Furthermore, this cohort was meant to serve as reference group in Paper III.
Paper III investigated the potential superiority of non-operative treatment vs. surgical volar plating
of displaced DRF in patients older than 65 years with regards to complications and functional
outcome. Volar plating is currently the recommended treatment according to the NCG.
Paper IV compared the functional outcome at the time points 2 and 5 weeks and 12 months in
between non-operatively treated minimally or non-displaced and displaced DRF with functional
outcome and complications as endpoints.
Paper V (to be published)
Paper V investigated the clinical outcome of minimally or non-displaced DRF in patients treated
non-operatively. The main purpose of this study was to provide data on patient outcome three years
or more after DRF and compare the results with the 12-month results. Outcome measures in this
study were complication, functional outcome, and post-traumatic articular arthrosis.
The findings of this thesis provide insight into the treatment of DRF in the elderly. Similar results in
terms of complication rates and functional outcomes were found in all groups. No clinical signs of
post-traumatic articular arthrosis were seen after more than 3 years of follow-up.
In the future, treatment of DRF in the elderly should rest on shared decision making
where the patient is actively involved in choosing the treatment strategy.
|
|---|
