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- Talk
- 17/08/2023
- UK
Distal Radius Fractures in the Elderly....What is the Evidence?
Description
In this presentation, Dr. Katrina Bell, a specialty registrar and clinical research fellow from Edinburgh, addresses the topic of distal radius fractures, focusing on their prevalence and the evidence that shapes current medical practices. She begins by highlighting the epidemiology of these fractures, noting they are the most common type treated by orthopedic surgeons and have a bimodal distribution, primarily affecting young men and older postmenopausal women. With projections indicating that by 2040, one in four people in the UK will be over 65, the anticipated rise in incidents of distal radius fractures becomes increasingly concerning.
The presentation explores the concept of predicting instability in fractures, summarizing key findings from various studies that identify factors such as age, comminution, and ulnar variance as predictors of fracture stability. Notably, she discusses the evolving understanding of malunion, suggesting it may not be as significant an issue as previously thought, as functional outcomes do not always correlate with radiological results.
Bell reviews various randomized control trials that assess treatment methods, particularly in elderly populations. Results from the Vulcan trial, Hassellund study, and others are highlighted, revealing that there often are no clinically significant differences in outcomes between surgical and non-surgical interventions, despite patient perceptions sometimes favoring operative treatments.
In closing, Bell summarizes the key messages from her presentation: the increasing incidence of distal radius fractures necessitates improved management strategies, factors influencing instability include age and fracture characteristics, and malunion should not be viewed with the same alarm as in the past. She emphasizes that randomized control trials have yielded largely similar results regarding patient outcomes, providing a nuanced understanding of treatment efficacy.