title: Comparison between external fixation and cast treatment in the management of distal radius fractures in patients aged 65 years and older.
abstract: OBJECTIVE
  The aim of this study was to compare the functional and radiographic outcomes of dorsally displaced distal radius fractures treated by closed reduction plaster cast fixation (CRPCF) and external fixation (EF) in patients 65 years and older.
  
  
  METHODS
  This retrospective and nonrandomized study comprised 46 consecutive patients older than 65 years who had distal radial fractures. Patients were divided into 2 groups according to treatment: a CRPCF group and an EF group. All the fractures were dorsally displaced and AO/ASIF type A or C, without articular stepoff or gap. Cases were evaluated based on the criteria of Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire score, wrist range of motion, and radiologic results.
  
  
  RESULTS
  The mean follow-up period was 25.1 months. Union was achieved in all cases. Although it was not a statistically significant difference, posttreatment complications were more common in the CRPCF group (10 patients) than in the EF group (7 patients). In the CRPCF group, most complications were discomfort from the cast, whereas in the EF group, most were pin site infections. The average wrist extension and ulnar deviation (clinically) and palmar tilt and radial height (radiologically) were statistically better in the EF group at the final follow-up. The mean DASH scores were 20.3 in the CRPCF group and 21.9 in the EF group. There was no statistically significant difference in the DASH scores; in wrist flexion, radial deviation, pronation, supination, grip strength, or pinch strength (clinically); or in ulnar variance or radial inclination (radiologically). There was no correlation between the DASH scores and palmar tilt and ulnar variance.
  
  
  CONCLUSIONS
  We concluded that both CRPCF and EF are useful methods for distal radius fractures in elderly patients. The results showed significant differences in wrist extension and ulnar deviation.
authors.affiliation: Ankara Numune Research and Training Hospital, Ankara, Turkey. cemnuri@yahoo.com
authors.forename: Cem Nuri
authors.initials: CN
authors.lastname: Aktekin
authors.forename: Murat
authors.initials: M
authors.lastname: Altay
authors.forename: Zeki
authors.initials: Z
authors.lastname: Gursoy
authors.forename: Lale Akbulut
authors.initials: LA
authors.lastname: Aktekin
authors.forename: Akif Muhtar
authors.initials: AM
authors.lastname: Ozturk
authors.forename: Abdullah Yalcin
authors.initials: AY
authors.lastname: Tabak
mesh_terms: D000368:Aged; D002370:Casts, Surgical / Q000009:adverse effects; D003100:Colles' Fracture / Q000000981:diagnostic imaging / Q000628:therapy*; D016267:External Fixators; D005260:Female; D005592:Fracture Fixation / Q000009:adverse effects; D006801:Humans; D008297:Male; D011859:Radiography