Eighteen percent of the breaks are distal radius fractures (DRF), one of the most frequent pathologies. This type of pathology occurs in young people, as a consequence of high energy trauma, and in elderly patients with osteoporosis, due to low energy trauma. In more than 40% of cases, these injuries are unstable, so that orthopedic treatment may be insufficient and unsatisfactory.
Treatment of distal radius
Currently, there is still no study in Plastic Surgery that shows a specific treatment depending on the type of fracture. Nevertheless, the most common method is the use of palmar locked plates. The advantages offered by this technique are a greater recovery, reduction of the fractured area and reduction of the possibilities of conflicts with the material used.
On the other hand, the application of bone grafts or bone substitutes is also frequent as a solution to distal radius fractures. This technique favors bone consolidation and avoids collapse. Its disadvantage is that the use of the materials has complications and increases the cost of the procedure.
Study of the radius fracture
Faced with a patient with a distal radius fracture with osteoporosis or breakage due to severe trauma, the specialist first performs an observational and descriptive study to classify the type of fracture according to the characteristics of the patient and of the breakage.
The study was carried out between January 2009 and January 2013, in 345 patients with unstable radius fracture and surgically intervened. Of the 60 who met the requirements and agreed to participate, 41 were women and 19 were men with a mean age of 57 years, ranging from 23 to 82 years. The injured wrist was the right in 41 cases and the left in the remaining 19. In all of them, osteosynthesis was performed, a surgical treatment in which the fracture is reduced and fixed in a stable manner by means of plates, screws, nails, wire or needles, among other elements. In no case was a bone graft or bone substitute used in the fracture.
The results were completely positive, in 80% of the cases the patients did not have any associated complication, three of them suffered tenosynovitis of the flexor tendons, inflammation of the synovial membrane, that is to say, of the tissue that covers the tendons; three others had symptoms of Carpal Tunnel Syndrome (CTS), one case of extensor tenosynovitis, one case of rupture of the extensor pollicis longus muscle of the thumb and one case of persistent pain in the distal radioulnar joint. 92% of the patients returned to their usual activity prior to surgery, with the operated wrist having a degree of mobility and flexion minimally inferior to their other healthy wrist.
Article based on the study: “Fractures of the distal radius: is bone graft or bone substitute necessary in cases with osteoporosis or severe comminution?” published in the Revista Española de CirugĂa OrtopĂ©dica y TraumatologĂa.