Description
The presentation delivered by Adam Watts, a consultant Upper Limb Surgeon from Wrightington Hospital, focuses on distal radius fractures in elderly patients, particularly questioning the effectiveness of traditional management tactics and whether Sir John Charnley was right in his historical assertions. He begins by establishing the prevalence of this type of fracture among elderly women and discusses the complexities involved in treating these injuries, emphasizing that distinct fracture types necessitate unique management approaches.
Watts highlights the frailty of elderly patients and their increased risk of falls, which significantly contributes to their susceptibility to such fractures. He references Charnley’s historic teachings on the management of fractures and emphasizes the importance of proper casting techniques to prevent complications following an initial injury. He explains that while cast immobilization has its merits, research indicates that many elderly patients may achieve satisfactory functional outcomes despite malunions.
Watts raises critical observations regarding the treatment of distal radius fractures, noting the high risk of redisplacement in elderly patients if they require fracture reduction. He argues that, although surgical options like volar locking plates have gained popularity, the outcomes in terms of functional recovery do not necessarily improve despite enhanced radiographic results. Overall, he conveys a cautious stance towards surgical interventions in the elderly, reiterating that excellent functional results can often accompany less-than-perfect anatomical reconstructions in distal radius fractures.