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Radiographic Outcomes of Distal Radial Fractures in Patients Over 90: Preoperative and Postoperative Correlations
Roya Khorram, MD
1, Bankole Olowofela, MD
1, Oluwatosin Oyedemi, BS
1, Ehsan Fayyazishishavan, PhD
2; Amir R Kachooei, MD PhD
1(1)Rothman Orthopaedics Florida at AdventHealth, Orlando, FL, (2)The University of Texas Health Science Center (UTHealth) at Houston, Houston, TX
Introduction: Distal radius fractures (DRFs) are common in the elderly, particularly nonagenarians, yet optimal management remains debated due to comorbidities and inconsistent evidence on surgical benefits. This study evaluates the correlation between radiographic and functional outcomes in nonagenarians undergoing surgical treatment for DRFs.
Materials & Methods : A retrospective review of 73 patients aged ?90 years with surgically treated DRFs was conducted. Radiographic parameters (dorsal tilt, ulnar variance, radial height, radial inclination) and functional outcomes (DASH, VAS scores) were assessed preoperatively, immediately postoperatively, and at final follow-up. Spearman's correlation analyzed relationships between outcomes.
Results: A total of 73 patients were studied, with a mean age of 92 ± 2 years. Dorsal tilt decreased from a preoperative mean of 17.40° (95% CI: 16.09, 18.71) to 11.78° (95% CI: 10.47, 13.08) immediately postoperatively and 10.45° (95% CI: 9.14, 11.76) at the final follow-up. Ulnar variance reduced from 2.95 mm (95% CI: 2.32, 3.57) preoperatively to 0.82 mm (95% CI: 0.19, 1.45) immediately postoperatively, with a slight increase to 1.36 mm (95% CI: 0.73, 1.98) at the final follow-up. Radial height improved from 9.14 mm (95% CI: 8.45, 9.83) to 10.79 mm at the immediate postoperative visit (95% CI: 10.11, 11.48) and was maintained at 10.37 mm (95% CI: 9.68, 11.06) at the final follow-up. Radial inclination increased from 17.61° (95% CI: 16.18, 19.04) to 21.93° (95% CI: 20.50, 23.36) immediately postoperatively and was stable at 21.27° (95% CI: 19.84, 22.70) at the final visit. We evaluated the DASH score at the final follow-up, which was 29.55 (95% CI: 24.06, 35.04). Concerning the VAS pain score, it decreased from 6.90 (95% CI: 6.43, 7.37) preoperatively to 3.21 (95% CI: 2.74, 3.67) and 0.60 (95% CI: 0.13, 1.07) at the immediate postoperative and final evaluations. Significant correlations were found between radiographic and functional outcomes, notably for radial height (?=0.44-0.73, p<0.001) and radial inclination (=0.47-0.77, p<0.001).
Conclusions: Surgical treatment of distal radius fractures in nonagenarians effectively restored radiographic alignment at the final follow-up. These changes correlated with significant pain relief and functional recovery, as shown by improved VAS and DASH scores. The procedure demonstrated safety and efficacy, supporting its role in optimizing outcomes for this frail population despite their elevated comorbidity risks.
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