title: Volar locking plate vs epibloc system for distal radius fractures in the elderly.
abstract: OBJECTIVE
  To compare clinical outcomes of ORIF with volar locking plates and the Epibloc system (ES) in the treatment of distal radius fractures (DRFs) in patients aged over 65 years.
  
  
  METHODS
  We retrospectively examined a consecutive series of 100 patients with intra-articular or extra-articular DRF who were admitted to our Department of Orthopaedics and Traumatology between January 2007 and January 2013. Fifty patients were treated using the Epibloc System; and the other 50 patients using ORIF with volar locking plates. In all patients, functional evaluation (wrist range of motion [ROM], grip strength and Disability of the Arm, Shoulder and Hand [DASH] Score) and radiographic assessment (radial inclination, volar tilt, ulnar variance and articular congruity) were performed at 2 and 6 weeks, and 3, 6 and 12 months postoperatively; then every 12 months thereafter.
  
  
  RESULTS
  ORIF with volar locking plates was associated with better outcome than ES in the intra-articular and extra-articular DRF groups, generating higher average ROM, DASH and visual analogue scale (VAS) scores. Grip strength mean values, however, were quantified over the minimum level for a functional wrist (>60%) in both groups. There were no differences between the two techniques in X-ray parameters, and no further correlation was found with functional outcome and ROM.
  
  
  CONCLUSIONS
  In a low-functioning patient with multiple medical comorbidities, minimally-invasive surgery with the ES is a safe option, enables early mobilisation of the wrist and is likely to produce acceptable clinical outcomes.
authors: Department of Neuroscience and Organs of Sense, Orthopaedics Section, Faculty of Medicine and Surgery, University of Bari, Bari, Italy.
authors: Giuseppe
authors: G
authors: Solarino
authors: Department of Neuroscience and Organs of Sense, Orthopaedics Section, Faculty of Medicine and Surgery, University of Bari, Bari, Italy. Electronic address: dott.gvicenti@gmail.com.
authors: Giovanni
authors: G
authors: Vicenti
authors: Department of Orthopaedics and Traumatology, Monsignor Raffaele Dimiccoli Hospital, Barletta, Italy.
authors: Antonella
authors: A
authors: Abate
authors: Department of Neuroscience and Organs of Sense, Orthopaedics Section, Faculty of Medicine and Surgery, University of Bari, Bari, Italy.
authors: Massimiliano
authors: M
authors: Carrozzo
authors: Department of Neuroscience and Organs of Sense, Orthopaedics Section, Faculty of Medicine and Surgery, University of Bari, Bari, Italy.
authors: Girolamo
authors: G
authors: Picca
authors: Department of Orthopaedics and Traumatology, Dario Camberlingo Hospital, Francavilla Fontana, Italy.
authors: Antonio
authors: A
authors: Colella
authors: Department of Neuroscience and Organs of Sense, Orthopaedics Section, Faculty of Medicine and Surgery, University of Bari, Bari, Italy.
authors: Biagio
authors: B
authors: Moretti
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001860:Bone Plates; D015897:Comorbidity; D004185:Disability Evaluation; D016267:External Fixators; D005260:Female; D005500:Follow-Up Studies; D005592:Fracture Fixation / Q000295:instrumentation; D018737:Hand Strength; D006801:Humans; D057072:Intra-Articular Fractures / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D007558:Italy; D008297:Male; D011885:Radius Fractures / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D016059:Range of Motion, Articular; D020127:Recovery of Function; D012189:Retrospective Studies; D016896:Treatment Outcome; D014955:Wrist Joint / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery
keywords: Distal radius fractures; Elderly patients; External fixation; Open reduction internal fixation; Volar locking plates