Distal radius fractures. Epidemiology, seasonal variation and results of palmar plate fixation.

Thesis event information

Date and time of the thesis defence

Place of the thesis defence

Oulu University Hospital, Auditorium 1 (Kajaanintie 50)

Topic of the dissertation

Distal radius fractures. Epidemiology, seasonal variation and results of palmar plate fixation.

Doctoral candidate

Licenciate of Medicine Kai Sirniö

Faculty and unit

University of Oulu Graduate School, Faculty of Medicine, Medical Research Center Oulu

Subject of study

Ortopedics and traumatology

Opponent

Professor Hannu Aro, Turku University Hospital

Custos

Professor Juhana Leppilahti, Oulu University Hospital

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Slippery weather conditions increase the risk of wrist fractures

Distal radius fractures (wrist fractures) are the most commonly encountered fall-related fracture in clinical practice. The aims of this thesis were to describe the epidemiology of wrist fractures in the city of Oulu during the year 2008 and to study the relationship between slippery conditions during the winter and the incidence of wrist fractures, to compare the results of primary nonoperative treatment and early operation (palmar plating) of primarily dislocated wrist fractures in patients ≥ 50 years old in an randomised controlled study and to investigate the rate and risk factors for plate-related complications after palmar plate fixation of 881 wrist fractures.

The crude incidence rate of wrist fractures was 258/100 000 person-years in Oulu in 2008, and the age-specific incidence rate in the female population aged ≥ 70 years was increased compared to previous studies in Finland and in Norway. A clear seasonal variation was observed in fall-related wrist fractures. The number of wrist fractures was 2.5 times higher on slippery winter days compared to non-winter days.

Early palmar plating of wrist fractures showed favourable functional results at two years compared to primary nonoperative treatment. Delayed surgery in the primary nonoperative treatment group did not provide comparable arm function to early plating.

The overall complication rate in the cohort of 881 plate-fixated wrist fractures was 15%. Operations performed by low-volume surgeons and patient ages < 40 years were independent predictors of plate-related complications.

In conclusion, the incidence of wrist fractures has increased during the last decades in Finland in elderly females, and slippery winter conditions increase the risk of wrist fractures. Early palmar plating of wrist fractures produces more consistent results compared to primary nonoperative treatment in patients ≥ 50 years old. The complication rate after palmar plating of wrist fractures is significantly influenced by surgeon experience and patient age.
Last updated: 21.11.2019