Distal Radius Fractures in Patients Over 70 Years - Volar Plate or Plaster

Dorsally Displaced Distal Radius Fractures in Patients Over 70 Years - Volar Plate or Plaster - A Prospective Randomized Trial

Distal radius fractures with dorsal dislocation among patients 70 years or older are randomized to conservative treatment with plaster or internal fixation with a volar plate. Thereafter they are followed at 2 weeks, 5 weeks, 3 months and 12 months with x-ray, functional scores and clinical examination.

An additional follow up at three years with X-ray, functional scores and clinical outcome will be conducted after a new written consent of continued participation in the study.

A health economy analysis will be preformed at 1, and 3 years for the participants with complete EQ5D.

Inclusion Criteria:

• Dorsally displaced, 20 degrees or from a plane perpendicular do the diaphyseal axis, fracture.
• Low energy injury
• Patient 70 years old or older
• 72 hours or less since injury at time of diagnosis
• Patient registered in the Stockholm region
• Patient understands spoken and written swedish

Exclusion Criteria:

• Intraarticular displacement in radiocarpal joint of more than 1 mm
• Ulna fractured proximal to the base of the styloid process of ulna
• Earlier unilateral functional impairment of hand/wrist
• Injury to tendon, nerve or skin besides the fracture
• Rheumatoid arthritis or other severe systemic joint disease
• Severe psychiatric disorder, ongoing drug abuse or dementia (Pfeiffer score 5 points or less)
• Besides the wrist fracture also other big injuries, for example fracture of hip, shoulder or ankle
• Medical illness that makes general anesthesia impossible