Review of Distal Radius Fracture in The Emergency Department of Baghdad Technical Hospital
Keywords:
Distal, Radius, Fractures, AO, Mechanism, EmergencyAbstract
Background
Wrist injuries are common, accounting for 2.5% of emergency department visits annually; distal radius fractures (DRFs) are among the most common types of fracture, have a bimodal distribution, with a peak in younger (aged 18-25 y) and older (>65 y) persons.
Aim of study:
To study the distal radius fracture characteristics and classification among a sample of Iraqi patients visited the emergency department in Baghdad Teaching Hospital.
Patients and methods:
A cross-sectional study was conducted at the surgical emergency department of Baghdad Teaching Hospital during the period from January 1st, 2013, to the 1st of 2013 to November 1, 2013. Forty patients (18 males and 22 females), their ages ranged between 8 -70 years, all with distal radius fracture, were selected regardless of their age or gender. Patients who had other types of fractures other than distal radius fractures, complicated traumatic injury, and were unconscious or refused to participate were excluded. Data were collected through full history and clinical examination of the patients by using a pre-constructed data collection sheet. Plane X-rays in all patients and laboratory investigations were performed accordingly. Management was performed under the supervision of the orthopedic residents,
The mean age of patients was 46.5 18.8 years, and the peak incidence (35%) was among patients aged 60. Right hand was the dominant injury side (92.5%), a housewife was 52.5% of the total patients, Diabetic was 57.5%,
FOSH, RTA, and sports injuries were the mechanisms of injuries in (72.5%,15%, and 12.5%), respectively. Regarding the AO classification, 23 A2 in 30%, 23A3 in 17.5%, 23 B1 class in 15%, and the least frequent was 23C3 in only one patient (2.5%). Females were significantly more likely to have class 23 A2 rather than males, 50 % vs. 5.6% respectively; in the contrary, males were more likely to have 23 A3 and 23 C2 class rather than females, P-0.009.
No statistically significant correlation had been found between the AO classification and age, history of chronic diseases, or mechanism of injury in all Comparisons P>0.05.
Conclusions:
Distal radius fracture incidence increased with the advancing age and the peak in elderly > 60 years. More common in females than males. Right-sided fractures are more frequent. According to the AO classification, males had more sever fractures than females.
References
Caldwell RA, Shorten PL, Morrell NT. Common Upper Extremity Fracture Eponyms: A Look into What They Really Mean. J Hand Surg Am. 2019 Apr;44 (4):331-334. [PubMed]
Meena S, Sharma P, Sambharia AK, Dawar A. Fractures of distal radius: an overview. J Family Med Prim Care. 2014 Oct-Dec;3 (4):325-32. [PMC free article] [PubMed]
Karl JW, Olson PR, Rosenwasser MP. The Epidemiology of Upper Extremity Fractures in the United States, 2009. J Orthop Trauma. 2015 Aug;29 (8): e242-4. [PubMed]
Naranje SM, Erali RA, Warner WC, Sawyer JR, Kelly DM. Epidemiology of Pediatric Fractures Presenting to Emergency Departments in the United States. J Pediatr Orthop. 2016 Jun;36 (4): e45-8. [PubMed]
Melton LJ, Amadio PC, Crowson CS, O'Fallon WM. Long-term trends in the incidence of distal forearm fractures. Osteoporos Int. 1998;8 (4):341-8. [PubMed]
Jerrhag D, Englund M, Karlsson MK, Rosengren BE. Epidemiology and time trends of distal forearm fractures in adults - a study of 11.2 million person-years in Sweden. BMC Musculoskelet Disord. 2017 Jun 02;18 (1):240. [PMC free article] [PubMed]
Vogt MT, Cauley JA, Tomaino MM, Stone K, Williams JR, Herndon JH. Distal radius fractures in older women: a 10-year follow-up study of descriptive characteristics and risk factors. The study of osteoporotic fractures. J Am Geriatr Soc. 2002 Jan;50 (1):97-103. [PubMed]
Rodríguez-Merchán EC. Pediatric fractures of the forearm. Clin Orthop Relat Res. 2005 Mar; (432):65-72. [PubMed]
Cepela DJ, Tartaglione JP, Dooley TP, Patel PN. Classifications In Brief: Salter-Harris Classification of Pediatric Physeal Fractures. Clin Orthop Relat Res. 2016 Nov;474 (11):2531-2537. [PMC free article] [PubMed]
Mauck BM, Swigler CW. Evidence-Based Review of Distal Radius Fractures. Orthop Clin North Am. 2018 Apr;49 (2):211-222. [PubMed]
Al-Amin Z, Senyürek SA, Van Lieshout EMM, Wijffels MME. Systematic review and pooled analysis of the rate of carpal tunnel syndrome after prophylactic carpal tunnel release in patients with a distal radius fracture. Hand Surg Rehabil. 2018 Jun;37 (3):155-159. [PubMed]
Pope D, Tang P. Carpal Tunnel Syndrome, and Distal Radius Fractures. Hand Clin. 2018 Feb;34 (1):27-32. [PubMed]
Walenkamp MM, Vos LM, Strackee SD, Goslings JC, Schep NW. The Unstable Distal Radius Fracture-How Do We Define It? A Systematic Review. J Wrist Surg. 2015 Nov;4 (4):307-16. [PMC free article] [PubMed]
Yim GH, Hardwicke JT. The Evolution and Interpretation of the Gustilo and Anderson Classification. J Bone Joint Surg Am. 2018 Dec 19;100 (24): e152. [PubMed]
Tseng PT, Leu TH, Chen YW, Chen YP. Hematoma block or procedural sedation and analgesia, which is the most effective method of anesthesia in the reduction of displaced distal radius fracture? J Orthop Surg Res. 2018 Mar 27;13 (1):62. [PMC free article] [PubMed]
Thelen S, Grassmann JP, Jungbluth P, Windolf J. [Distal radius fractures: Current treatment concepts and controversies]. Chirurg. 2018 Oct;89 (10):798-812. [PubMed]
Loisel F, Bourgeois M, Rondot T, Nallet J, Boeckstins M, Rochet S, Leclerc G, Obert L, Lepage D. Treatment goals for distal radius fractures in 2018: recommendations and practical advice. Eur J Orthop Surg Traumatol. 2018 Dec;28 (8):1465-1468. [PubMed]
