Summary

The aim of the study is to improve the results of treatment of patients with fractures of the distal radius

Abstract

Fractures of the distal metaepiphysis of the forearm bones are the most common injuries and account for 11% of all fractures, 33.2% of long tubular bone injuries, and up to 60-90% of forearm bone injuries. Being, in fact, damages of the proximal wrist joint, fractures of the distal metaepiphysis have a pronounced sexual dimorphism and occur as a result of minimal trauma in women (84.5%), which allows us to refer them to the consequences of postmenopausal osteoporosis.
Despite the intensive development of methods of surgical treatment of radial bone fractures in the typical site, according to various authors, unsatisfactory treatment outcomes account for an average of 35%. The issues of differentiated treatment tactics for the different mechanisms of injury and intensity of the traumatic factor, especially for multi-joint and intra-articular fractures, which, in their turn, lead to complications in the form of clubfoot, contractures in the wrist joint, and neurodystrophic syndrome, remain unsolved.
The aim of the study is to improve the results of treatment of patients with fractures of the distal radius.
The authors analyzed the results of operative and conservative treatment 128 patients aged 60-74 years (mean age 67.2±1.2 years) with fractures of the distal metaepiphysis of the radial bone. Male was – 17 (13.3%), female – 111 (86.7%). According to AO/ASIF classification the fracture was type ? – 6 (4.7%); type ? – 25 (19.5%); type ? – 97 (75.8%). According to the method of treatment all patients were divided into 2 groups (1 - operative and 2 - conservative treatment) and each group into 2 subgroups (basic and control). The results of treatment were assessed using the DASH scale.
Under the conditions of the experiment, due to the calculation of the relative modulus of elasticity, it was found that the specific density and discontinuity of the spongy bone tissue are significantly reduced in the area of 10 - 18 mm from the articular surface. It was found that the lowest values of the distribution of spongy bone tissue and cortical layer are observed in the segment of the styloid process.
The average follow-up was 49.3±0.7 months (from 1 to 7 years) after trauma. The tendency of transition to more complex intra-articular fractures with increasing average age of patients is revealed. Approaches to the treatment of patients of different age groups, including those caused by traumatic factors of varying intensity, have been developed. According to the results of treatment of 128 patients with fractures of the distal metaepiphysis of the radial bone using the proposed differentiated tactics of treatment and use of immobilization splint, which allowed to perform functional unloading of the radial wrist joint, positive results were obtained in 93.92% (p<0.001) of cases.