Outcome Analysis of Adult Distal Radius Fractures Managed during COVID-19 Pandemic.

Abstract

COVID-19 pandemic created extreme pressure situation on health care services across the globe with shortage of medical staff and beds. The management of fragility fracture also affected significantly. The distal radius fractures (DRFs) are one of the common frailty fractures. There was a significant shift in the treatment of such injuries with new guidelines leaning toward more of non-operative management. A retrospective cross-sectional study of DRFs (DRF) treated during COVID pandemic for a period of 1 year in the United Kingdom. This included all radiologically confirmed cases of DRFs with isolated adult injuries excluding polytrauma, same limb other injuries, associated neurovascular injuries, and age below 18 years. All patient's data were collected from hospital records retrospectively from April 2020 to March 2021. There were a total of 179 patients with distal radius fracture, of which 141 (78.8%) were females and 38 (21.2%) males. The mean age was 68.2 years (SD 68.20 ± 15.63) and there were greater number of patients with intra-articular fracture. There were 28.5% (Grades 1 and 2, Group I) extra-articular fractures; 69.8% (Grades 3-8, Group II) were intra-articular fractures and 3 Barton's fractures (Group III) accounted to 1.7%. 137 patients were (76.5%) treated to non-operatively and 42 (23.5%) were treated surgically. 135 (75.4%) patients had good and 43 (24%) satisfactory clinical outcomes. 3 (1.6%) patients required osteotomy for malunited fractures. Fracture grade I and II is significantly associated with non-operative procedure (100.0% vs 84.3%) with P < 0.001. This study confirmed that non-operative treatment is still a good option even in intra-articular fractures. Surgical fixation should be considered in young patients and those with higher grade of fracture classification and greater angulation at presentation. A virtual physiotherapy is still a good option.