Abstract
ABSTRACT Distal radius fractures (DRFs) are commonly encountered in the elderly population, secondary to low-energy injury mechanisms. In the younger population, DRFs are mainly secondary to high-energy trauma. Stable DRFs can be treated conservatively. However, in the elderly population group, DRFs are often unstable and are likely to benefit from surgical intervention. They are often compounded by comorbid medical conditions requiring optimisation. When treating the elderly group, one should be aware of sarcopaenia, as this may have a bearing on return to function. Recent literature reports an increasing trend in the surgical management of these fractures. Current classification systems fail to consistently guide the management of these fractures. Although evidence is still limited in guiding decision-making in the treatment of these fractures, one should consider the economic implications of prolonged immobilisation in young patients in addition to defined indications for surgery. Improvement in implants allows safe dorsal fixation in patients with dorsal comminution, with low complication rates reported. This narrative review summarises current trends and the body of evidence. Level of evidence: Level 5 Keywords: distal radius, fracture management, osteoporosis
Highlights
Having noted a trend of steady increase in life expectancy globally, the World Health Organization (WHO) declared the years 2020 to 2030 as a decade of healthy ageing
Acute carpal tunnel syndrome (CTS) has been reported in 5.4–8.6% of patients with Distal radius fractures (DRFs)
The presence of sarcopaenia has been reported to be prevalent in elderly patients with DRFs and it is closely associated with osteoporosis
Summary
Having noted a trend of steady increase in life expectancy globally, the World Health Organization (WHO) declared the years 2020 to 2030 as a decade of healthy ageing. Most people over the age of 60 years live in low- to middle-income countries.[1] In South Africa, as of mid-2020, the estimated life expectancy was 68.5 and 62.5 years for females and males respectively, showing a steady annual increase.[2] Distal radius fractures (DRFs) are the second most common fragility fracture.[3] About 1.5% of the patients treated in the emergency unit will present with DRFs, of which 5–17% are due to low-energy injury mechanisms in osteoporotic patients.[4,5,6] In an epidemiological review of the Swedish registry, Rundgren et al noted a higher prevalence of DRFs in females over the age of 50 years compared to males of the same age.[7] The incidence of DRFs in young adults is low, and usually follows high-energy trauma or sports-related injuries, often presenting with complex fracture patterns.[8,9,10]
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